Chen Yu-Wei, Tucker Matthew D, Brown Landon C, Yasin Hesham A, Ancell Kristin K, Armstrong Andrew J, Beckermann Kathryn E, Davis Nancy B, Harrison Michael R, Kaiser Elizabeth G, McAlister Renee K, Schaffer Kerry R, Wallace Deborah E, George Daniel J, Rathmell W Kimryn, Rini Brian I, Zhang Tian
Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA.
Grandview Cancer Center, Alabama Oncology, 3670 Grandview Pkwy, Birmingham, AL 35243, USA.
Cancers (Basel). 2022 Aug 7;14(15):3830. doi: 10.3390/cancers14153830.
A lower baseline neutrophil-to-eosinophil ratio (NER) has been associated with improved responses to immune checkpoint inhibitors (ICI)-treated metastatic renal cell carcinoma (mRCC). This study investigated the decrease in NER at week 6 after ipilimumab/nivolumab (ipi/nivo) initiation and treatment responses in mRCC. A retrospective study of ipi/nivo-treated mRCC at two US academic cancer centers was conducted. A landmark analysis at week 6 was performed to assess the association between the change in NER and clinical responses (progression-free survival (PFS)/overall survival (OS)). Week 6 NER was modeled as a continuous variable, after log transformation (Ln NER), and a categorical variable by percent change. There were 150 mRCC patients included: 78% had clear cell histology, and 78% were IMDC intermediate/poor risk. In multivariable regression analysis, every decrease of 1 unit of Ln NER at week 6 was associated with improved PFS (adjusted hazard ratio (AHR): 0.78, p-value:0.005) and OS (AHR: 0.67, p-value: 0.002). When NER was modeled by percent change, decreased NER > 50% was associated with improved PFS (AHR: 0.55, p-value: 0.03) and OS (AHR: 0.37, p-value: 0.02). The decrease in week 6 NER was associated with improved PFS/OS in ipi/nivo-treated mRCC. Prospective studies are warranted to validate NER change as a biomarker to predict ICI responses.
较低的基线中性粒细胞与嗜酸性粒细胞比值（NER）与免疫检查点抑制剂（ICI）治疗的转移性肾细胞癌（mRCC）的反应改善相关。本研究调查了伊匹单抗/纳武单抗（ipi/nivo）开始治疗后第6周NER的下降情况以及mRCC的治疗反应。对美国两个学术癌症中心接受ipi/nivo治疗的mRCC进行了一项回顾性研究。在第6周进行了一项标志性分析，以评估NER变化与临床反应（无进展生存期（PFS）/总生存期（OS））之间的关联。第6周的NER经对数转换（Ln NER）后作为连续变量建模，并按百分比变化作为分类变量建模。纳入了150例mRCC患者：78%为透明细胞组织学，78%为IMDC中/低风险。在多变量回归分析中，第6周Ln NER每降低1个单位与PFS改善相关（调整后风险比（AHR）：0.78，p值：0.005）和OS改善相关（AHR：0.67，p值：0.002）。当NER按百分比变化建模时，NER降低>50%与PFS改善相关（AHR：0.55，p值：0.03）和OS改善相关（AHR：0.37，p值：0.02）。在接受ipi/nivo治疗的mRCC中，第6周NER的下降与PFS/OS改善相关。有必要进行前瞻性研究以验证NER变化作为预测ICI反应的生物标志物。
