Chemotherapy: Open Access
Open Access

Abstract

Association of New Inflammatory Markers Cumulative Inflammatory Index (ICC) and Mean Corpuscular Volume/Lymphocyte (MCVL) with Anti PD-1 Antibody Nivolumab Treatment Response in Metastatic Renal Cell Carcinoma

Heves Surmeli*, Deniz Isik, Hamit Bal, Salih Tunbekici, Oguzcan Kinikoglu, Yunus Emre Altintas, Goncagul Akdag and Sedat Yildirim

Introduction: Kidney cancer is an immunogenic tumor and inflammation plays a role in tumor formation and progression. The aim of this study was to investigate the effect of biochemical markers in predicting treatment response in patients with metastatic Renal Cell Carcinoma (RCC) receiving nivolumab treatment.

Methods: Patients aged ≥ 18 years who received nivolumab treatment for metastatic RCC between February, 2022 and January, 2024 were evaluated. Cellular blood count was evaluated at the diagnosis of metastatic disease and periodically during nivolumab treatment. We measured the cell count in peripheral blood at admission and calculated the inflammation indices obtained from the blood cell count as follows: MCVL (Mean Corpuscular Volume/Lymphocytes) and IIC ((mean corpuscular volume *width of erythrocyte distribution* neutrophils/(lymphocytes*1000)).

Results: The study included 99 patients. The mean age of the patients was 58.32 ± 11.95 (19-87). 75.8% of the patients had clear cell and 8.1% had papillary type pathology. When the disease control status was evaluated at 3 months after nivolumab treatment, it was seen that 48 patients had partial response and 18 patients remained stable. The 3^rd month Disease Control Rate (DCR) was 68.7%. When the ICIC and MCVL rates of the patients were examined, it was determined that the ICC and MCVL values of the patients who showed progression were higher (p=0.038 for ICC, p=0.040 for MCVL). The ICC cut-off value was determined as 15.50. With this cut-off value, disease control can be predicted with 77% sensitivity and 64% specificity (AUC: 0.743 CI 95% (0.647-0.838); p<0.001). MCVL cut-off value was determined as 65.15. This cut-off value can predict disease control with 65% sensitivity and 61% specificity (AUC: 0.674, CI: 95% (0.564-0.783), p=0.006).

Conclusion: Cumulative Inflammatory Index (ICC) and MCVL have a significant effect on disease-free survival and overall survival in predicting success of nivolumab treatment for metastatic renal cell carcinoma.

Published Date: 2024-12-19; Received Date: 2024-11-18