Neutrophil-to-lymphocyte Ratio, Platelet-to-lymphocyte Ratio, and C-reactive Protein as New and Simple Prognostic Factors in Patients With Metastatic Renal Cell Cancer Treated With Tyrosine Kinase Inhibitors: A Systemic Review and Meta-analysis

• Published in: Clinical genitourinary cancer 2018-06, Vol.16 (3), p.e685-e693
• Main Authors: Semeniuk-Wojtaś, Aleksandra, Lubas, Arkadiusz, Stec, Rafał, Syryło, Tomasz, Niemczyk, Stanisław, Szczylik, Cezary
• Format: Article
• Language: English
• Subjects: C-reactive protein; C-Reactive Protein - metabolism; Carcinoma, Renal Cell - blood; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - metabolism; Clinical Trials, Phase I as Topic; Clinical Trials, Phase II as Topic; Female; Humans; Kidney Neoplasms - blood; Kidney Neoplasms - drug therapy; Kidney Neoplasms - metabolism; Leukocyte Count; Lymphocyte Count; Male; Neutrophil-to-lymphocyte ratio; Neutrophils - cytology; Platelet Count; Platelet-to-lymphocyte ratio; Prognosis; Prognostic factors; Prospective Studies; Protein Kinase Inhibitors - therapeutic use; Renal cell cancer; Survival Analysis
• ISSN: 1558-7673; 1938-0682
• DOI: 10.1016/j.clgc.2018.01.010

The analysis comparing the prognostic value of inflammation markers in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors demonstrates that host immune markers could be valuable predictors of clinical outcome. The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and C-reactive protein provide additional information about patient status and might be helpful in improving the treatment individualization. Inflammation plays a crucial role in cancer development. In this study, we evaluate the prognostic values of systemic inflammation markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) for the progression-free survival and overall survival in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors. PubMed and the Cochrane Library databases were searched for published studies on the effect of NLR, PLR, and CRP in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors. In the meta-analysis, NLR (hazard ratio [HR], 2.01; 95% confidence interval [CI], 1.27-3.18; P = .003) and PLR (HR, 6.96; 95% CI, 5.04-9.62; P < .001) had a significant influence on progression-free survival, whereas all considered proinflammatory markers had a significant impact on overall survival: NLR (HR, 2.14; 95% CI, 1.67-2.73; P < .001), PLR (HR, 14.67; 95% CI, 11.10-19.57; P < .001), and CRP (HR, 1.96; 95% CI, 1.26-3.05; P = .003). Inflammation markers such as NLR, PLR, and CRP are predictors of clinical outcome and could provide additional information to individualize treatment.