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Observational Study
. 2025 Jan;17(1):25-35.
doi: 10.1080/1750743X.2025.2452145. Epub 2025 Jan 20.

Role of Hb to RDW ratio in metastatic renal cell carcinoma patients treated with first-line immunotherapy combinations

Matilde Corianò  1   2 , Alessandro Lazzarin  1   2 , Michele Maffezzoli  1   2 , Matteo Santoni  3 , Giulia Mazzaschi  1   2 , Sara Rodella  4 , Nicola Simoni  5 , 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  1   2 , Enrico Maria Silini  1   16 , Federico Quaini  1 , Massimo De Filippo  17 , Matteo Brunelli  18 , Giuseppe L Banna  19   20 , Pasquale Rescigno  21 , Alessio Signori  22 , Sebastiano Buti  1   2
Affiliations
Observational Study

Role of Hb to RDW ratio in metastatic renal cell carcinoma patients treated with first-line immunotherapy combinations

Matilde Corianò et al. Immunotherapy. 2025 Jan.

Abstract

Background: The present study aimed to investigate the prognostic and predictive roles of Hb/RDW ratio in patients with mRCC treated with first-line immunotherapy combinations (TKI plus ICI or ICI plus ICI).

Materials and methods: We performed a sub-analysis of a multicenter retrospective observational study (ARON-1 project) involving patients with mRCC treated with first-line immunotherapy combinations.

Results: Three hundred and twenty-nine patients were enrolled, 244 males and 85 females. Median age was 65.5 years. The prognostic impact of the Hb/RDW ratio on PFS and OS was observed in the whole population examined. Hb/RDW ratio had a correlation with neutrophil-to-lymphocyte ratio (NLR), a blood inflammatory parameter.

Conclusion: Hb/RDW ratio is a new inflammatory prognostic factor, easy to use in daily clinical practice.

Keywords: NLR; Prognostic score; RDW; hemoglobin; immune checkpoint inhibitors; metastatic renal cell carcinoma; ratio; tyrosine-kinase inhibitors.

Plain language summary

This study examined patients with advanced kidney cancer treated with immunotherapy combinations, focusing on the Hb/RDW ratio, a simple measure from routine blood tests comparing hemoglobin levels to red blood cell size variation. The findings showed that patients with a lower Hb/RDW ratio had shorter survival. This suggests that the Hb/RDW ratio could be a useful tool for predicting patient outcomes. The ratio’s association with inflammation, which is known to influence cancer progression, may explain its significance. The hope is that the Hb/RDW ratio could help doctors make better treatment decisions for patients with advanced kidney cancer.

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Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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