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
. 2025:43:100927.
doi: 10.1016/j.ctarc.2025.100927. Epub 2025 Apr 26.

The prognostic value of the haemoglobin/red cell distribution width ratio in a cohort of pre-treated patients with renal cell carcinoma receiving nivolumab

Giulia Claire Giudice  1 , Sara Elena Rebuzzi  2 , Giulia Mazzaschi  1 , Federica Pecci  3 , Michele Maffezzoli  1 , Alessandro Acunzo  4 , Letizia Gnetti  5 , Enrico Maria Silini  6 , Giuseppe Caruso  7 , Elena Rapacchi  7 , Pasquale Rescigno  8 , Giuseppe Fornarini  9 , Giuseppe Luigi Banna  10 , Sebastiano Buti  1
Affiliations
Free article

The prognostic value of the haemoglobin/red cell distribution width ratio in a cohort of pre-treated patients with renal cell carcinoma receiving nivolumab

Giulia Claire Giudice et al. Cancer Treat Res Commun. 2025.
Free article

Abstract

Background: Metastatic renal cell carcinoma (mRCC) has a dismal prognosis. Effective prognostic and predictive factors are needed. A higher haemoglobin (Hb) / red cell distribution width (RDW) ratio is known to be related to better outcomes. Here we evaluated the prognostic value of the Hb/RDW ratio in pre-treated mRCC patients receiving nivolumab.

Material and methods: This is a sub-analysis of the retrospective Meet-URO 15 study, on pre-treated patients with mRCC, receiving nivolumab. The first objective was to investigate the prognostic role of Hb/RDW ratio, in terms of overall survival (OS) and progression-free survival (PFS).

Results: 356 were included in the present analysis. Patients were mainly males with a median age of 63 years. We classified patients in high and low Hb/RDW ratio, according to two different cut-offs: 0.9frequently used in literature, and 0.7, result of the time-dependent AUC analysis.. Median OS and PFS were 22.3 months (95 %CI 19.4-29.0) and 5.6 months (95 %CI 4.74.-7.53), respectively. At univariable analysis, higher Hb/RDW ratio was related to longer OS (p < 0.001) and PFS (p = 0.011); the multivariable model confirmed only the association between a Hb/RDW ratio ≥ 0.7 and better OS.

Conclusions: The Hb/RDW ratio is a manageable and practical prognostic tool in patients with cancer; its prognostic value for OS was confirmed in pre-treated mRCC patients, receiving nivolumab, only using a cut-off value derived from a time-dependent AUC.

Keywords: Hb/RDW ratio; Meet URO 15; Prognostic factor; Renal cell carcinoma.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This study was not supported by any sponsor or funder. Prof Buti received honoraria as a speaker at scientific events and advisory role by BMS, Pfizer, MSD, Ipsen, Roche, Eli Lilly, AstraZeneca, Pierre-Fabre, Novartis, Merck, Gentili, Astellas. Dr Rebuzzi received honoraria as speaker at scientific events and travel accommodation from BMS, Amgen, GSK, Ipsen, Astellas, Janssen, MSD. The other authors declare no potential conflicts of interest with respect to research, authorship and/or publication of this article.

MeSH terms

LinkOut - more resources