1 research outputs found
Early CRP kinetics to predict longâterm efficacy of firstâline immuneâcheckpoint inhibition combination therapies in metastatic renal cell carcinoma: an updated multicentre realâworld experience applying different CRP kinetics definitions
Abstract Objectives Although biomarkers predicting therapy response in firstâline metastatic renal carcinoma (mRCC) therapy remain to be defined, Câreactive protein (CRP) kinetics have recently been associated with immunotherapy (IO) response. Here, we aimed to assess the predictive and prognostic power of two contemporary CRP kinetics definitions in a large, realâworld firstâline mRCC cohort. Methods Metastatic renal carcinoma patients treated with IOâbased firstâline therapy within 5âyears were retrospectively included in this multicentre study. According to Fukuda et al., patients were defined as âCRP flareâresponderâ, âCRP responderâ and ânonâCRP responderâ; according to Ishihara et al., patients were defined as ânormalâ, ânormalisedâ and ânonânormalisedâ based on their early CRP kinetics. Patient and tumor characteristics were compared, and treatment outcome was measured by overall (OS) and progressionâfree survival (PFS), including multivariable Cox regression analyses. Results Out of 316 mRCC patients, 227 (72%) were assigned to CRP groups according to Fukuda. Both CRP flareâ (HR [Hazard ratio]: 0.59) and CRP responders (HR: 0.52) had a longer PFS, but not OS, than nonâCRP responders. According to Ishihara, 276 (87%) patients were assigned to the respective groups, and both normal and normalised patients had a significantly longer PFS and OS, compared with nonânormalised group. Conclusion Different early CRP kinetics may predict therapy response in firstâline mRCC therapy in a large realâworld cohort. However, further research regarding the optimal timing and frequency of measurement is needed