Prognostic value of pan-immune-inflammation value and body mass index in geriatric patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors as first line treatment. A single-center retrospective study

Piotr Domański; Jadwiga Jarosińska; Barbara Kruczyk; Mateusz Piętak; Anna Mydlak; Tomasz Demkow; Łukasz Kuncman; Marta Darewicz; Bożena Sikora-Kupis; Wojciech Michalski; Jakub Kucharz

doi:10.5114/wo.2023.134786

Prognostic value of pan-immune-inflammation value and body mass index in geriatric patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors as first line treatment. A single-center retrospective study

Contemp Oncol (Pozn). 2023;27(4):242-248. doi: 10.5114/wo.2023.134786. Epub 2024 Jan 30.

Authors

Affiliations

¹ Department of Genitourinary Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
² Department of Experimental Immunotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
³ Department of Radiotherapy, Medical University of Łódź, Poland.
⁴ Department of External Beam Radiotherapy, Nicolaus Copernicus Multidisciplinary Center for Oncology and Traumatology, Łódź, Poland.
⁵ Department of Oncological Mathematics, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland.

Abstract

Introduction: Geriatric patients with metastatic renal cell carcinoma (mRCC) are underrepresented in clinical trials. Evaluation of the efficacy of the treatment and assignation of individuals to proper prognostic groups is an absolute necessity to guarantee them the best possible care.

Material and methods: A total of 138 geriatric patients with mRCC treated with first-line tyrosine kinase inhibitors (TKIs) at the Maria Skłodowska-Curie National Research Institute of Oncology were retrospectively analyzed to determine whether the body mass index (BMI) and pan-immune-inflammation value (PIV) are prognostic values for overall survival (OS) and progression-free survival (PFS) in this type of cancer. For this purpose, Cox's proportional hazard model was used.

Results: The median duration of follow-up for surviving patients was 46.6 (95% CI: 17.4-75.8) months. The median OS and PFS were respectively 33.8 months (95% CI: 23.8-47.8) and 19.1 months (95% CI: 15.0-23.3). BMI (p = 0.034) and PIV (p < 0.001) were statistically significantly associated with OS, and PIV (p = 0.001) was statistically significantly associated with PFS. The risk of death for patients from the high-PIV group (cut-off point: 548) was 3.4 times higher than for those with lower PIV values. The corresponding risk of progression for patients from the high-PIV group was 2.2 times higher. The G8 geriatric screening tool was not identified as a prognostic factor.

Conclusions: Lower PIV and obesity are associated with longer OS in geriatric mRCC patients treated with TKIs in the first line. These factors may be considered while making treatment decisions if further studies show the same results.

Keywords: biomarkers; body mass index (BMI); geriatric; metastatic renal cell carcinoma (mRCC); pan-immune-inflammation value (PIV); tyrosine kinase inhibitors (TKIs).