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On-treatment C-reactive protein control could predict response to subsequent anti-PD-1 treatment in metastatic renal cell carcinoma

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Abstract

Objective

The aim of this study was to evaluate the clinical significance of the on-treatment C-reactive protein (CRP) status during systemic treatment as the predictive marker for the response of subsequent nivolumab monotherapy in patients with refractory metastatic renal cell carcinoma (mRCC).

Patients and methods

A total of 73 mRCC patients treated with nivolumab were retrospectively reviewed. We evaluated the serum CRP levels before and after molecular-targeted treatments. Patients whose CRP did not exceed baseline value were defined as the CRP-control group and the others were defined as the CRP-progression group. The clinical impact of CRP-control on the efficacy of nivolumab was assessed.

Results

Twenty-four patients (33%) were categorized into the CRP-control group. The CRP-control group patients (median PFS not reached) had significantly longer PFS than the CRP-progression group (median PFS 11.9 months, 95% confidence interval, CI 4.1–19.8, p = 0.038). The CRP-control group had a tendency of longer OS from nivolumab initiation than the CRP-progression group (p = 0.071). By multivariate analysis, the on-treatment CRP-control was the independent predictive factor for PFS (hazard ratio HR 0.37, 95% CI 0.14–0.99, p = 0.047).

Conclusion

The on-treatment CRP-control could be the predictive factor for the efficacy of nivolumab in refractory mRCC patients.

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Acknowledgements

Supported in part by grants-in-aid from the Ministry of Education, Science, Sports, and Culture of Japan (20K09585 to R.M. and 19K16807 to K.T.)

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 1608582, Japan

    Kimiharu Takamatsu, Ryuichi Mizuno, Yota Yasumizu, Nobuyuki Tanaka, Toshikazu Takeda, Shinya Morita, Kazuhiro Matsumoto, Takeo Kosaka, Hiroshi Asanuma & Mototsugu Oya

  2. Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan

    Yuto Baba, Suguru Shirotake & Masafumi Oyama

  3. Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan

    Shuji Mikami

Authors
  1. Kimiharu Takamatsu
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  2. Ryuichi Mizuno
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  3. Yuto Baba
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  4. Yota Yasumizu
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  5. Nobuyuki Tanaka
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  6. Suguru Shirotake
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  7. Toshikazu Takeda
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  8. Shinya Morita
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  9. Kazuhiro Matsumoto
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  10. Takeo Kosaka
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  11. Hiroshi Asanuma
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  12. Masafumi Oyama
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  13. Shuji Mikami
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  14. Mototsugu Oya
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Corresponding author

Correspondence to Ryuichi Mizuno.

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Conflict of interests

Ryuichi Mizuno MD has received honoraria from Bristol, Novartis, and Pfizer. Mototsugu Oya MD has received honoraria from Bayer, Bristol, Novartis, and Pfizer. Other authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was waived by the local Ethics Committee of Keio University in view of the retrospective nature of the study. All procedures performed in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Because this was a retrospective cohort study, informed consent was waived. Opt out was done on the web site of Keio University.

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Takamatsu, K., Mizuno, R., Baba, Y. et al. On-treatment C-reactive protein control could predict response to subsequent anti-PD-1 treatment in metastatic renal cell carcinoma. Int J Clin Oncol 26, 1500–1505 (2021). https://doi.org/10.1007/s10147-021-01930-y

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  • DOI: https://doi.org/10.1007/s10147-021-01930-y

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