Although biomarkers predicting therapy response in first-line metastatic renal carcinoma (mRCC) therapy remain to be defined, C-reactive protein (CRP) kinetics have recently been associated with immunotherapy (IO) response. Here, we aimed to assess the predictive and prognostic power of two contemporary CRP kinetics definitions in a large, real-world first-line mRCC cohort.
Metastatic renal carcinoma patients treated with IO-based first-line therapy within 5 years were retrospectively included in this multicentre study. According to Fukuda et al., patients were defined as 'CRP flare-responder', 'CRP responder' and 'non-CRP responder'; according to Ishihara et al., patients were defined as 'normal', 'normalised' and 'non-normalised' based on their early CRP kinetics. Patient and tumor characteristics were compared, and treatment outcome was measured by overall (OS) and progression-free survival (PFS), including multivariable Cox regression analyses.
Out of 316 mRCC patients, 227 (72%) were assigned to CRP groups according to Fukuda. Both CRP flare- (HR [Hazard ratio]: 0.59) and CRP responders (HR: 0.52) had a longer PFS, but not OS, than non-CRP responders. According to Ishihara, 276 (87%) patients were assigned to the respective groups, and both normal and normalised patients had a significantly longer PFS and OS, compared with non-normalised group.
Different early CRP kinetics may predict therapy response in first-line mRCC therapy in a large real-world cohort. However, further research regarding the optimal timing and frequency of measurement is needed.
Clinical & translational immunology. 2023 Oct 25*** epublish ***
Benedikt Hoeh, Cristina Cano Garcia, Severine Banek, Niklas Klümper, Alexander Cox, Jörg Ellinger, Philipp Schmucker, Oliver Hahn, Angelika Mattigk, Friedemann Zengerling, Philippe Becker, Kati Erdmann, Bjoern Thorben Buerk, Luka Flegar, Johannes Huber, Charis Kalogirou, Philip Zeuschner
Department of Urology University Hospital Frankfurt, Goethe University Frankfurt am Main Frankfurt Germany., Department of Urology University Hospital Bonn (UKB) Bonn Germany., Department of Urology and Paediatric Urology Julius Maximilians University Medical Centre of Würzburg Würzburg Germany., Department of Urology and Paediatric Urology University Hospital Ulm Ulm Germany., Department of Urology and Paediatric Urology Saarland University Homburg/Saar Germany., Department of Urology, University Hospital Carl Gustav Carus Technische Universität Dresden Dresden Germany., Department of Urology Philipps-University Marburg Marburg Germany.