The Association between a Decrease in On-Treatment Neutrophil-to-Eosinophil Ratio (NER) at Week 6 after Ipilimumab Plus Nivolumab Initiation and Improved Clinical Outcomes in Metastatic Renal Cell Carcinoma

Yu Wei Chen, Matthew D. Tucker, Landon C. Brown, Hesham A. Yasin, Kristin K. Ancell, Andrew J. Armstrong, Kathryn E. Beckermann, Nancy B. Davis, Michael R. Harrison, Elizabeth G. Kaiser, Renee K. McAlister, Kerry R. Schaffer, Deborah E. Wallace, Daniel J. George, W. Kimryn Rathmell, Brian I. Rini, Tian Zhang

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Abstract

A lower baseline neutrophil-to-eosinophil ratio (NER) has been associated with improved responses to immune checkpoint inhibitors (ICI)-treated metastatic renal cell carcinoma (mRCC). This study investigated the decrease in NER at week 6 after ipilimumab/nivolumab (ipi/nivo) initiation and treatment responses in mRCC. A retrospective study of ipi/nivo-treated mRCC at two US academic cancer centers was conducted. A landmark analysis at week 6 was performed to assess the association between the change in NER and clinical responses (progression-free survival (PFS)/overall survival (OS)). Week 6 NER was modeled as a continuous variable, after log transformation (Ln NER), and a categorical variable by percent change. There were 150 mRCC patients included: 78% had clear cell histology, and 78% were IMDC intermediate/poor risk. In multivariable regression analysis, every decrease of 1 unit of Ln NER at week 6 was associated with improved PFS (adjusted hazard ratio (AHR): 0.78, p-value:0.005) and OS (AHR: 0.67, p-value: 0.002). When NER was modeled by percent change, decreased NER > 50% was associated with improved PFS (AHR: 0.55, p-value: 0.03) and OS (AHR: 0.37, p-value: 0.02). The decrease in week 6 NER was associated with improved PFS/OS in ipi/nivo-treated mRCC. Prospective studies are warranted to validate NER change as a biomarker to predict ICI responses.

Original languageEnglish (US)
Article number3830
JournalCancers
Volume14
Issue number15
DOIs
StatePublished - Aug 2022

Keywords

  • eosinophil
  • immune checkpoint inhibitor
  • kidney cancer
  • NER
  • neutrophil-to-eosinophil ratio
  • renal cell carcinoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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