Albumin levels predict prognosis in advanced renal cell carcinoma treated with tyrosine kinase inhibitors: a systematic review and meta-analysis

• Published in: Urologic oncology 2022-01, Vol.40 (1), p.12.e13-12.e22
• Main Authors: Zhou, Xinyi, Fu, Guanghou, Zu, Xiongbing, Xu, Zhijie, Li, Hong-Tao, D'souza, Anishka, Tulpule, Varsha, Quinn, David I, Bhowmick, Neil A, Weisenberger, Daniel J, Liang, Gangning, Chen, Jinbo
• Format: Article
• Language: English
• Subjects: Advanced/metastatic renal cell carcinoma; Albumin; Carcinoma, Renal Cell - blood; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - mortality; Carcinoma, Renal Cell - secondary; Disease-Free Survival; Humans; Kidney Neoplasms - blood; Kidney Neoplasms - drug therapy; Kidney Neoplasms - mortality; Kidney Neoplasms - pathology; Meta-analysis; Predictive Value of Tests; Prognosis; Protein Kinase Inhibitors - therapeutic use; Protein-Tyrosine Kinases - antagonists & inhibitors; Serum Albumin - analysis; Survival Rate; Tyrosine kinase inhibitor
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2021.08.001

•Investigated albumin's role in the prognosis of mRCC patients treated with TKI•Quantitative synthesis incorporated 2,863 participants from 14 studies•Lower pre-treatment albumin is an independent adverse predictor of OS and PFS With the development of therapy and prognostic criteria for metastatic Renal Cell Carcinoma (mRCC), the prognostic value of serum albumin level has remained in dispute. The aim of this meta-analysis was to evaluate the role of pre-treatment albumin in predicting the prognosis of mRCC patients in the era of tyrosine kinase inhibitor (TKI) treatments. The qualitative and quantitative synthesis was conducted of studies retrieved from PubMed, Embase, and Cochrane library from inception of these databases to July 19, 2020. The hazard ratio (HR) and its 95% confidence interval (CI) of overall survival (OS) and progression-free survival (PFS) were extracted from studies comparing different levels of pre-treatment serum albumin (as a dichotomous or continuous variable) in mRCC patients treated with TKI agents. Within 5,638 primitive records, 16 were eligible and 14 had adequate data for quantitative analysis (N = 2,863 participants). Random-effects meta-analysis showed that lower albumin was related to poorer OS (dichotomous: HR = 2.01, 95% CI: 1.64-2.46, P < 0.001, I2 = 28.8%; continuous: HR =0.93, 95% CI: 0.86-1.00, P = 0.040, I2 = 67.5%) and PFS (dichotomous: HR = 1.45, 95% CI: 1.04-2.01, P = 0.029, I2 = 57.4%; continuous: HR = 0.89, 95% CI: 0.80-0.98, P = 0.023, I2 = 93.3%). Lower pre-treatment serum albumin level is an independent adverse predictor of prognosis of mRCC patients receiving TKI therapy. PROSPERO ID: CRD42020196802 Sep. 2nd, 2020