Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 Apr;41(2):117-129.
doi: 10.1007/s10585-024-10266-6. Epub 2024 Feb 16.

External validation of a red cell-based blood prognostic score in patients with metastatic renal cell carcinoma treated with first-line immunotherapy combinations

Michele Maffezzoli #  1   2 , Matteo Santoni #  3 , Giulia Mazzaschi  4   5 , Sara Rodella  4 , Eleonora Lai  6 , Marco Maruzzo  6 , Umberto Basso  6 , Davide Bimbatti  6 , Roberto Iacovelli  7 , Annunziato Anghelone  7 , Ondřej Fiala  8   9 , Sara Elena Rebuzzi  10   11 , Giuseppe Fornarini  12 , Cristian Lolli  13 , Francesco Massari  14 , Matteo Rosellini  14 , Veronica Mollica  14 , Cecilia Nasso  15 , Alessandro Acunzo  4   5 , Enrico Maria Silini  4   16 , Federico Quaini  4 , Massimo De Filippo  17 , Matteo Brunelli  18 , Giuseppe L Banna  19   20 , Pasquale Rescigno  21 , Alessio Signori #  22 , Sebastiano Buti #  4   5
Affiliations
Observational Study

External validation of a red cell-based blood prognostic score in patients with metastatic renal cell carcinoma treated with first-line immunotherapy combinations

Michele Maffezzoli et al. Clin Exp Metastasis. 2024 Apr.

Abstract

Immunotherapy combinations with tyrosine-kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) had significantly improved outcomes of patients with mRCC. Predictive and prognostic factors are crucial to improve patients' counseling and management. The present study aimed to externally validate the prognostic value of a previously developed red cell-based score, including hemoglobin (Hb), mean corpuscular volume (MCV) and red cell distribution width (RDW), in patients with mRCC treated with first-line immunotherapy combinations (TKI plus ICI or ICI plus ICI). We performed a sub-analysis of a multicentre retrospective observational study (ARON-1 project) involving patients with mRCC treated with first-line immunotherapy combinations. Uni- and multivariable Cox regression models were used to assess the correlation between the red cell-based score and progression-free survival (PFS), and overall survival (OS). Logistic regression were used to estimate the correlation between the score and the objective response rate (ORR). The prognostic impact of the red cell-based score on PFS and OS was confirmed in the whole population regardless of the immunotherapy combination used [median PFS (mPFS): 17.4 vs 8.2 months, HR 0.66, 95% CI 0.47-0.94; median OS (mOS): 42.0 vs 17.3 months, HR 0.60, 95% CI 0.39-0.92; p < 0.001 for both]. We validated the prognostic significance of the red cell-based score in patients with mRCC treated with first-line immunotherapy combinations. The score is easy to use in daily clinical practice and it might improve patient counselling.

Keywords: Blood; Immunotherapy combination; Mean corpuscular volume; Metastatic renal cell carcinoma; Prognostic score; Red cell distribution width.

PubMed Disclaimer

Conflict of interest statement

Dr. Rebuzzi received honoraria as speaker at scientific events and travel accomodation by BMS, Amgen, GSK, Janssen, Astellas, Ipsen, MSD.

Figures

Fig. 1
Fig. 1
Representative Kaplan–Meier survival curve illustrating the impact of the red cell-based score on PFS
Fig. 2
Fig. 2
Representative Kaplan–Meier survival curve illustrating the impact of the red cell-based score on OS
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Rini BI, Plimack ER, Stus V, et al. Pembrolizumab plus axitinib versus sunitinib for advanced renal-cell carcinoma. N Engl J Med. 2019;380(12):1116–1127. doi: 10.1056/NEJMoa1816714. - DOI - PubMed
    1. Motzer R, Alekseev B, Rha SY, et al. lenvatinib plus pembrolizumab or everolimus for advanced renal cell carcinoma. N Engl J Med. 2021;384(14):1289–1300. doi: 10.1056/NEJMoa2035716. - DOI - PubMed
    1. Choueiri TK, Motzer RJ, Rini BI, et al. Updated efficacy results from the JAVELIN Renal 101 trial: first-line avelumab plus axitinib versus sunitinib in patients with advanced renal cell carcinoma. Ann Oncol. 2020;31(8):1030–1039. doi: 10.1016/j.annonc.2020.04.010. - DOI - PMC - PubMed
    1. Choueiri TK, Powles T, Burotto M, et al. nivolumab plus cabozantinib versus sunitinib for advanced renal-cell carcinoma. N Engl J Med. 2021;384(9):829–841. doi: 10.1056/NEJMoa2026982. - DOI - PMC - PubMed
    1. Motzer RJ, Tannir NM, McDermott DF, et al. nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma. N Engl J Med. 2018;378(14):1277–1290. doi: 10.1056/NEJMoa1712126. - DOI - PMC - PubMed

Publication types