治疗期间C反应蛋白的控制情况可预测转移性肾细胞癌对后续抗PD-1治疗的反应。

On-treatment C-reactive protein control could predict response to subsequent anti-PD-1 treatment in metastatic renal cell carcinoma.

作者信息

Takamatsu Kimiharu, Mizuno Ryuichi, Baba Yuto, Yasumizu Yota, Tanaka Nobuyuki, Shirotake Suguru, Takeda Toshikazu, Morita Shinya, Matsumoto Kazuhiro, Kosaka Takeo, Asanuma Hiroshi, Oyama Masafumi, Mikami Shuji, Oya Mototsugu

机构信息

Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 1608582, Japan.

Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan.

出版信息

Int J Clin Oncol. 2021 Aug;26(8):1500-1505. doi: 10.1007/s10147-021-01930-y. Epub 2021 Jun 8.

DOI:10.1007/s10147-021-01930-y

PMID:34101038

Abstract

OBJECTIVE

The aim of this study was to evaluate the clinical significance of the on-treatment C-reactive protein (CRP) status during systemic treatment as the predictive marker for the response of subsequent nivolumab monotherapy in patients with refractory metastatic renal cell carcinoma (mRCC).

PATIENTS AND METHODS

A total of 73 mRCC patients treated with nivolumab were retrospectively reviewed. We evaluated the serum CRP levels before and after molecular-targeted treatments. Patients whose CRP did not exceed baseline value were defined as the CRP-control group and the others were defined as the CRP-progression group. The clinical impact of CRP-control on the efficacy of nivolumab was assessed.

RESULTS

Twenty-four patients (33%) were categorized into the CRP-control group. The CRP-control group patients (median PFS not reached) had significantly longer PFS than the CRP-progression group (median PFS 11.9 months, 95% confidence interval, CI 4.1-19.8, p = 0.038). The CRP-control group had a tendency of longer OS from nivolumab initiation than the CRP-progression group (p = 0.071). By multivariate analysis, the on-treatment CRP-control was the independent predictive factor for PFS (hazard ratio HR 0.37, 95% CI 0.14-0.99, p = 0.047).

CONCLUSION

The on-treatment CRP-control could be the predictive factor for the efficacy of nivolumab in refractory mRCC patients.

摘要

目的

本研究旨在评估全身治疗期间治疗中C反应蛋白（CRP）状态作为难治性转移性肾细胞癌（mRCC）患者后续纳武利尤单抗单药治疗反应预测标志物的临床意义。

患者与方法

回顾性分析73例接受纳武利尤单抗治疗的mRCC患者。我们评估了分子靶向治疗前后的血清CRP水平。CRP未超过基线值的患者被定义为CRP对照组，其他患者被定义为CRP进展组。评估CRP对照对纳武利尤单抗疗效的临床影响。

结果

24例患者（33%）被归类为CRP对照组。CRP对照组患者（中位无进展生存期未达到）的无进展生存期明显长于CRP进展组（中位无进展生存期11.9个月，95%置信区间，CI 4.1 - 19.8，p = 0.038）。CRP对照组从纳武利尤单抗开始治疗后的总生存期有长于CRP进展组的趋势（p = 0.071）。多因素分析显示，治疗中CRP对照是无进展生存期的独立预测因素（风险比HR 0.37，95% CI 0.14 - 0.99，p = 0.047）。