Monteiro Fernando Sabino Marques, Fiala Ondřej, Massari Francesco, Myint Zin W, Kopecky Jindrich, Kucharz Jakub, Büttner Thomas, Grande Enrique, Bourlon Maria Teresa, Molina-Cerrillo Javier, Pichler Renate, Buchler Tomas, Seront Emmanuel, Ansari Jawaher, Bamias Aristotelis, Bhuva Dipen, Vau Nuno, Porta Camillo, Fay Andre Poisl, Santoni Matteo
Latin American Cooperative Oncology Group - LACOG, Porto Alegre, RS, Brazil; Hospital Sirio Libanês, Brasilia, DF, Brazil; PUCRS School of Medicine, Porto Alegre, RS, Brazil.
Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital, Charles University, Pilsen, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
Clin Genitourin Cancer. 2024 Apr;22(2):305-314.e3. doi: 10.1016/j.clgc.2023.11.013. Epub 2023 Nov 24.
Systemic treatment with immune combinations is the gold standard for metastatic renal cell carcinoma (mRCC) worldwide. The systemic immune-inflammation index (SII) is a prognostic marker for several types of malignant neoplasms, including mRCC, in the era of tyrosine kinase inhibitor (TKI) treatment. Data regarding the prognostic value of the SII in patients with mRCC treated with immunotherapy are scarce and controversial. METHODS: We retrospectively collected the data of patients with mRCC from 56 centers in 18 countries. SII (Platelet × Neutrophil/Lymphocyte count) was calculated prior to the first systemic treatment and cut-off was defined by a survival receiver operating characteristic (ROC) analysis. The primary objective of our retrospective study was to assess the outcomes of patients treated with first-line immunotherapy. RESULTS: Data from 1034 mRCC patients was collected and included in this analysis. The SII cut-off value was 1265. After a follow-up of 26.7 months, and the overall survival (OS) and progression-free survival (PFS) were 39.8 and 15.7 months, respectively. According to SII (low vs. high), patients with low-SII had longer OS (55.7 vs. 22.2 months, P < .001), better PFS (20.8 vs. 8.5 months, P < .001), and higher overall response rate (52 vs. 37%, P = .033).
A high SII is associated with poor oncological outcomes in patients with mRCC. SII could be an easily accessible prognostic indicator for use in clinical practice.
免疫联合全身治疗是全球转移性肾细胞癌（mRCC）的金标准。在酪氨酸激酶抑制剂（TKI）治疗时代，全身免疫炎症指数（SII）是包括mRCC在内的几种恶性肿瘤的预后标志物。关于SII在接受免疫治疗的mRCC患者中的预后价值的数据稀缺且存在争议。
我们回顾性收集了来自18个国家56个中心的mRCC患者的数据。在首次全身治疗前计算SII（血小板×中性粒细胞/淋巴细胞计数），并通过生存受试者工作特征（ROC）分析确定临界值。我们这项回顾性研究的主要目的是评估接受一线免疫治疗患者的预后。
收集并纳入了1034例mRCC患者的数据进行分析。SII临界值为1265。随访26.7个月后，总生存期（OS）和无进展生存期（PFS）分别为39.8个月和15.7个月。根据SII（低与高），SII低的患者OS更长（55.7个月对22.2个月，P < .001），PFS更好（20.8个月对8.5个月，P < .001），总缓解率更高（52%对37%，P = .033）。
高SII与mRCC患者不良的肿瘤学预后相关。SII可能是一种易于获取的预后指标，可用于临床实践。
