Lymphocytes are closely linked to mechanisms of action of immuno-oncology (IO) agents. We aimed to assess the prognostic significance of absolute lymphocyte count (ALC) in patients with metastatic renal cell carcinoma (mRCC).
Using the International mRCC Database Consortium (IMDC), patients receiving first-line IO-based combination therapy were analysed. Baseline patient characteristics, objective response rates (ORRs), time to next treatment (TTNT), and overall survival (OS) were compared.
Of 966 patients included, 195 (20%) had lymphopenia at baseline, and they had a lower ORR (37% versus 45%; P < 0.001), shorter TTNT (10.1 months versus 24.3 months; P < 0.001), and shorter OS (30.4 months versus 48.2 months; P < 0.001). Among 125 patients with lymphopenia at baseline, 52 (42%) experienced ALC recovery at 3 months, and they had longer OS (not reached versus 30.4 months; P = 0.012). On multivariable analysis for OS, lymphopenia was an independent adverse prognostic factor (hazard ratio 1.68; P < 0.001). Incorporation of lymphopenia into the IMDC criteria improved OS prediction accuracy (C-index from 0.688 to 0.707).
Lymphopenia was observed in one-fifth of treatment-naive patients with mRCC and may serve as an indicator of unfavourable oncologic outcomes in the contemporary IO era.
ESMO open. 2024 Jun 19 [Epub ahead of print]
K Takemura, T Yuasa, A Lemelin, E Ferrier, J C Wells, E Saad, R M Saliby, N S Basappa, L A Wood, E Jude, S K Pal, F Donskov, B Beuselinck, B Szabados, T Powles, R R McKay, G Gebrael, N Agarwal, T K Choueiri, D Y C Heng
Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. Electronic address: ., Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan., Tom Baker Cancer Centre, University of Calgary, Calgary., BC Cancer Agency, Vancouver, Canada., Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA., Cross Cancer Institute, University of Alberta, Edmonton., Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Canada., Olivia Newton-John Cancer Wellness & Research Centre, Heidelberg, Australia., City of Hope Comprehensive Cancer Center, Duarte, USA., Aarhus University Hospital, Aarhus; University Hospital of Southern Denmark, Esbjerg, Denmark., Leuven Cancer Institute, KU Leuven, Leuven, Belgium., Barts Cancer Institute, Queen Mary University of London, London, UK., Moores Cancer Center, University of California San Diego, La Jolla., Huntsman Cancer Institute, University of Utah, Salt Lake City, USA., Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA. Electronic address: https://twitter.com/DrChoueiri., Tom Baker Cancer Centre, University of Calgary, Calgary. Electronic address: https://twitter.com/DrDanielHeng.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38901174
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