Clinica di Oncologia Medica, AOU 'Ospedali Riuniti', Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy.
Br J Cancer. 2013 Oct 1;109(7):1755-9. doi: 10.1038/bjc.2013.522. Epub 2013 Sep 5.
Everolimus is a mammalian target of rapamycin inhibitor approved for the treatment of metastatic renal cell carcinoma (mRCC). We aimed to assess the association between pre-treatment neutrophil-to-lymphocyte ratio (NLR) and the outcome of patients treated with everolimus for mRCC.
Ninety-seven patients with mRCC were treated with everolimus till April 2013 in our institutions. Patients were stratified in two groups with NLR >3 (Group A) vs <3 (Group B). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier method. Gender, age, Motzer prognostic group, PFS on first-line therapy, neutrophilia and NLR were included in the Cox analysis to investigate their prognostic relevance.
Median OS and PFS were 10.6 and 5.3 months, respectively. Median OS was 12.2 months in Group A and 24.4 months in Group B (P=0.001). Median PFS was 3.4 months in Group A and 9.9 months in Group B (P<0.001). At multivariate analysis, only Motzer prognostic group and NLR were independent prognostic factors for OS and PFS.
Pre-treatment NLR is an independent prognostic factor for patients with mRCC treated with second- or third-line everolimus. This should be investigated and validated in prospective studies.
依维莫司是一种哺乳动物雷帕霉素靶蛋白抑制剂，已被批准用于治疗转移性肾细胞癌（mRCC）。我们旨在评估治疗转移性肾细胞癌患者的依维莫司前中性粒细胞与淋巴细胞比值（NLR）与患者结局之间的相关性。
97 例 mRCC 患者于 2013 年 4 月前在我院接受依维莫司治疗。根据 NLR>3（A 组）和 NLR<3（B 组）将患者分为两组。采用 Kaplan-Meier 法估计无进展生存期（PFS）和总生存期（OS）。性别、年龄、Motzer 预后分组、一线治疗 PFS、中性粒细胞增多和 NLR 纳入 Cox 分析，以探讨其预后相关性。
中位 OS 和 PFS 分别为 10.6 个月和 5.3 个月。A 组的中位 OS 为 12.2 个月，B 组为 24.4 个月（P=0.001）。A 组的中位 PFS 为 3.4 个月，B 组为 9.9 个月（P<0.001）。多因素分析显示，只有 Motzer 预后分组和 NLR 是 OS 和 PFS 的独立预后因素。
治疗转移性肾细胞癌患者的依维莫司前 NLR 是独立的预后因素。这应在前瞻性研究中进行研究和验证。
