演題抄録

口演

開催概要
開催回
第58回・2020年・京都
 

転移性腎癌に対するニボルマブ治療中の好塩基球/好中球比の変化率と予後の関係の検討

演題番号 : O36-2

[筆頭演者]
石山 雄大:1 
[共同演者]
近藤 恒徳:1、橘 秀和:1、福田 洋典:2、石原 弘喜:2、吉田 一彦:2、高木 敏男:2、飯塚 淳平:2、田邉 一成:2

1:東京女子医科大学東医療センター・泌尿器科、2:東京女子医科大学・泌尿器科

 

Among numerous clinical biomarkers reported for the prediction of immune-checkpoint inhibitor (ICI) treatment in metastatic renal cell carcinoma (mRCC), the impact of eosinophil-to-lymphocyte ratio (ELR), let alone it's dynamism, has not been clarified. We hypothesized and investigated whether dynamic change in ELR during nivolumab therapy is associated with the survival of mRCC patients.
We retrospectively evaluated 57 mRCC patients treated with nivolumab following one or more systematic therapies. ELR was calculated at following timepoints: before nivolumab initiation (baseline), 1 month after initiation, and every 2 months afterwards, as long as nivolumab was administered. Patients with ELR decreased to < 20% of the baseline were defined as the largely declined (LD) group. Treatment response was defined according to RECIST ver. 1.1. Primary outcomes were progression-free survival (PFS) and overall survival (OS) after nivolumab initiation.
The median follow-up period was 21.5 (IQR: 15.1-33.3) months and 14 (24.6%) patients were categorized in the LD group. Both PFS and OS was significantly shorter in the LD group than in the non-LD group (1-year PFS: 23.2% v 41.9%, p=0.0172/1-year OS: 64.2% v 90.2%, p=0.0037). Objective response rate (ORR; CR+PR) and disease control rate (DCR; CR+PR+SD) tended to be lower in the LD group but did not reach significance (ORR: 21.4% v 45.2%, p=0.1036/DCR: 64.3% v 78.6%, p=0.2970). When only patients with disease control (CR+PR+SD) were included, PFS and OS were significantly worse for the LD group than for the non-LD group (1-year PFS: 38.1% v 50.4%, p=0.0312/1-year OS: 62.5% v 93.6%, p<0.001).
A large decline in ELR was associated with poor prognosis in mRCC patients undergoing nivolumab treatment, irrespective of best treatment response. The result of this study suggests that antibody production, such as IgE by eosinophil, and its balance against lymphocytes is essential in achieving long-term response and survival in ICI treatment.

キーワード

臓器別:腎・尿路・膀胱

手法別:免疫療法

前へ戻る