Evidence map›Paper›PMID 29041991›Full record

ArticleJournal for immunotherapy of cancer2017

Neutrophil lymphocyte ratio and duration of prior anti-angiogenic therapy as biomarkers in metastatic RCC receiving immune checkpoint inhibitor therapy.

Ghayathri Jeyakumar, Seongho Kim, Naresh Bumma, Craig Landry, Cynthia Silski, Stacey Suisham, Brenda Dickow, Elisabeth Heath, Joseph Fontana, Ulka Vaishampayan

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal for immunotherapy of cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ghayathri JeyakumarDepartment of Oncology, Karmanos Cancer Institute/Wayne State University, 4 HWCRC 4100 John R, Detroit, MI, 48201, USA.
Seongho KimBiostatistics Core, Karmanos Cancer Institute, Department of Oncology, School of Medicine, Wayne State University, Detroit, MI, USA.
Naresh BummaDepartment of Oncology, Karmanos Cancer Institute/Wayne State University, 4 HWCRC 4100 John R, Detroit, MI, 48201, USA.
Craig LandryDepartment of Oncology, Karmanos Cancer Institute/Wayne State University, 4 HWCRC 4100 John R, Detroit, MI, 48201, USA.
Cynthia SilskiDepartment of Oncology, Karmanos Cancer Institute/Wayne State University, 4 HWCRC 4100 John R, Detroit, MI, 48201, USA.
Stacey SuishamDepartment of Oncology, Karmanos Cancer Institute/Wayne State University, 4 HWCRC 4100 John R, Detroit, MI, 48201, USA.
Brenda DickowDepartment of Oncology, Karmanos Cancer Institute/Wayne State University, 4 HWCRC 4100 John R, Detroit, MI, 48201, USA.
Elisabeth HeathDepartment of Oncology, Karmanos Cancer Institute/Wayne State University, 4 HWCRC 4100 John R, Detroit, MI, 48201, USA.
Joseph FontanaDepartment of Oncology, Karmanos Cancer Institute/Wayne State University, 4 HWCRC 4100 John R, Detroit, MI, 48201, USA.
Ulka VaishampayanDepartment of Oncology, Karmanos Cancer Institute/Wayne State University, 4 HWCRC 4100 John R, Detroit, MI, 48201, USA. vaishamu@karmanos.org.

Funding

Tumor Biology and Microenvironment (Program 1)P30CA022453 · NCI · WAYNE STATE UNIVERSITY · PI Julie Lynn Boerner · 1985 to 2026
$68.4M
NCI NIH HHS P30 CA022453
6 · The paper itself

Abstract

backgroundThere is an unmet need to determine factors predictive of clinical benefit, to guide therapeutic sequencing and selection in metastatic RCC (mRCC). We evaluated clinical factors such as the neutrophil lymphocyte ratio (NLR) and duration of prior anti-vascular endothelial growth factor (VEGF) inhibitors, as predictors of response rate, progression free survival (PFS) and overall survival (OS) in mRCC patients treated with immune checkpoint inhibitor (ICI).

methodsRegulatory approval was obtained. A single center retrospective chart review of mRCC patients at Karmanos Cancer Institute, treated with ICI based therapy (PD-1/PD-L1 inhibitors) was conducted. Data were collected on demographics, smoking status, prognostic scoring (Memorial Sloan Kettering and Heng criteria), NLR pretherapy, post 1 and 4 doses of ICI, and duration of prior anti-VEGF therapy ≥6 months or <6.

results42 patients were evaluated with median age of 61 years (range, 24-85). Pretherapy NLR < 3 and ≥3 was seen in 19 (45%) and 23 (55%) patients, respectively. 24 (57%) and 18 (43%) patients had prior anti-VEGF inhibitors for a duration of ≥6 months and <6 months, respectively. 12 (29%), 22 (52%) and 8 (19%) patients had favorable, intermediate and poor risk disease based on Heng criteria, respectively. Multivariable analysis showed pretherapy NLR ≥3 was predictive of shorter PFS and OS when treated with ICI with median 3.08 months and 13.50 months, respectively, versus 15.57 months and not reached for NLR < 3 (adjusted p-values =0.003 and 0.025, respectively). Prior anti-VEGF therapy <6 months was predictive of increased likelihood of benefit from ICI therapies (adjusted p = 0.028). The median PFS was 3.72 months and 14.33 months, respectively, in cases with prior anti-VEGF therapy for ≥6 months and <6 months.

conclusionPretherapy NLR <3 and duration of prior anti-VEGF therapy of <6 months, are independent statistically significant predictors of longer PFS and OS with ICI therapy in mRCC. Validation is required in a larger sample size with multi-institutional collaboration.

Indexed as

AdultAgedAged, 80 and overBiomarkers, TumorCarcinoma, Renal CellFemaleHumansKidney NeoplasmsLymphocytesMaleMiddle AgedNeutrophilsProtein Kinase InhibitorsTreatment OutcomeYoung AdultBiomarkers, TumorProtein Kinase InhibitorsBiomarkersImmune checkpoint inhibitorsKidney cancerNeutrophil lymphocyte ratioPredictivePrognostic marker

Identifiers

PMID29041991
PMCPMC5646127

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.