Serum C-reactive Protein Level Predicts Overall Survival for Clear Cell and Non-Clear Cell Renal Cell Carcinoma Treated with Ipilimumab plus Nivolumab

Yusuke Yano; Takaya Ohno; Kazumasa Komura; Wataru Fukuokaya; Taizo Uchimoto; Takahiro Adachi; Yosuke Hirasawa; Takeshi Hashimoto; Atsuhiko Yoshizawa; Shogo Yamazaki; Satoshi Tokushige; Kazuki Nishimura; Takuya Tsujino; Keita Nakamori; Shutaro Yamamoto; Kosuke Iwatani; Fumihiko Urabe; Keiichiro Mori; Takafumi Yanagisawa; Shunsuke Tsuduki; Kiyoshi Takahara; Teruo Inamoto; Jun Miki; Takahiro Kimura; Yoshio Ohno; Ryoichi Shiroki; Haruhito Azuma

doi:10.3390/cancers14225659

Serum C-reactive Protein Level Predicts Overall Survival for Clear Cell and Non-Clear Cell Renal Cell Carcinoma Treated with Ipilimumab plus Nivolumab

Cancers (Basel). 2022 Nov 17;14(22):5659. doi: 10.3390/cancers14225659.

Authors

Yusuke Yano¹, Takaya Ohno¹, Kazumasa Komura¹, Wataru Fukuokaya², Taizo Uchimoto¹, Takahiro Adachi³, Yosuke Hirasawa³, Takeshi Hashimoto³, Atsuhiko Yoshizawa⁴, Shogo Yamazaki¹, Satoshi Tokushige¹, Kazuki Nishimura¹, Takuya Tsujino¹, Keita Nakamori¹, Shutaro Yamamoto², Kosuke Iwatani², Fumihiko Urabe², Keiichiro Mori², Takafumi Yanagisawa², Shunsuke Tsuduki², Kiyoshi Takahara⁴, Teruo Inamoto¹, Jun Miki², Takahiro Kimura², Yoshio Ohno³, Ryoichi Shiroki⁴, Haruhito Azuma¹

Affiliations

¹ Department of Urology, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City 569-8686, Japan.
² Department of Urology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan.
³ Department of Urology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
⁴ Department of Urology, Fujita-Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Japan.

Abstract

Serum C-reactive protein (CRP) is known to be a biomarker for systemic inflammatory reactions. In the present study, we sought to measure the predictive value of serum CRP level for metastatic renal cell carcinoma (mRCC) treated with first-line ipilimumab and nivolumab using our real-world clinical dataset including non-clear cell RCC (nccRCC). The clinical record of patients who underwent the first-line ipilimumab plus nivolumab treatment for mRCC including ccRCC and nccRCC from 2018 to 2021 was retrospectively analyzed. All patients were diagnosed with either intermediate or poor-risk group defined by IMCD (international metastatic RCC database consortium). In total, 74 patients were involved. The median age was 68 years and 24 (32.4%) patients deceased during the follow-up. Forty-five (61%) and 29 (39%) patients were classified into intermediate and poor-risk groups. The one-year overall survival (OS) rate and objective response rate were 65% and 41% for all 74 mRCC patients, respectively. The receiver operating characteristic curve identified 1.0 mg/dL of serum CRP level as an ideal cut-off for predicting overall survival (OS). Serum CRP > 1.0 mg/dL and nccRCC were the independent predictors for OS in 74 mRCC patients. OS for patients with CRP > 1 mg/dL was significantly shorter than those with CRP < 1 mg/dL in both ccRCC (58 patient: p = 0.009) and nccRCC (16 patients: p = 0.008). The present study indicated that serum CRP level is a prognostic indicator for OS in both ccRCC and nccRCC patients treated with the first-line ipilimumab plus nivolumab treatment.

Keywords: C-reactive protein; ipilimumab; nivolumab; renal cell carcinoma.

Grants and funding

This study was partially supported by Grant-in-Aid No. 21H03070 (Japan Society for the Promotion of Science), the Osaka Medical Research Foundation for Intractable Disease, and the Takeda Science Foundation in Japan.