RT Journal Article
SR Electronic
T1 Albumin-to-Alkaline Phosphatase Ratio as a Novel Prognostic Marker of Nivolumab Monotherapy for Previously Treated Metastatic Renal Cell Carcinoma
JF In Vivo
JO In Vivo
FD International Institute of Anticancer Research
SP 2855
OP 2862
DO 10.21873/invivo.12573
VO 35
IS 5
A1 MAKI YOSHINO
A1 HIROKI ISHIHARA
A1 YUDAI ISHIYAMA
A1 HIDEKAZU TACHIBANA
A1 DAISUKE TOKI
A1 KAORI YAMASHITA
A1 HIROHITO KOBAYASHI
A1 HIRONORI FUKUDA
A1 KAZUHIKO YOSHIDA
A1 TOSHIO TAKAGI
A1 JUNPEI IIZUKA
A1 HIDEKI ISHIDA
A1 TSUNENORI KONDO
A1 KAZUNARI TANABE
YR 2021
UL http://iv.iiarjournals.org/content/35/5/2855.abstract
AB Background/Aim: The relationship between albumin-to-alkaline phosphatase ratio (AAPR) and the outcome of patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors remains unresolved. We aimed to clarify the prognostic role of AAPR in nivolumab monotherapy for previously treated mRCC. Patients and Methods: We retrospectively evaluated 60 patients with mRCC treated with nivolumab after failure of at least one molecular targeted therapy. The patients were stratified into two groups based on the baseline AAPR. The threshold of AAPR was determined using receiver-operating characteristics and Youden index analyses. Overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) of nivolumab therapy were compared between the high and low AAPR groups. Results: The threshold of AAPR was set at 0.3, and 20 patients (33%) were assigned to the low AAPR group. The median OS and PFS were significantly lower in the low AAPR group than those in the high group (OS: 8.3 months vs. not reached, p<0.0001; PFS: 2.9 vs. 10.4 months, p=0.0006). Moreover, ORR was significantly lower in the low AAPR group than in the high group (16% vs. 45%, p=0.0397). Multivariate analyses further showed that AAPR was an independent factor for OS [HR=0.27 (95% CI=0.09-0.77), p=0.0151] but not for PFS (p=0.174). Conclusion: Baseline AAPR was significantly associated with outcome in patients with mRCC receiving nivolumab monotherapy and may, therefore, constitute an effective prognostic factor for nivolumab treatment.