Sodium levels and immunotherapy efficacy in mRCC patients with bone metastases: sub analysis of Meet-Uro 15 study

被引：5

作者：

Catalano, Martina ^{[1
]}

Rebuzzi, Sara Elena ^{[2
,3
]}

Maruzzo, Marco ^{[4
]}

De Giorgi, Ugo ^{[5
]}

Buti, Sebastiano ^{[6
,7
]}

Galli, Luca ^{[8
]}

Fornarini, Giuseppe ^{[9
]}

Zucali, Paolo Andrea ^{[10
,11
]}

Claps, Melanie ^{[12
]}

Chiellino, Silvia ^{[13
]}

Zampiva, Ilaria ^{[14
]}

Pipitone, Stefania ^{[15
]}

Ricotta, Riccardo ^{[16
]}

Soraru, Mariella ^{[17
]}

Mollica, Veronica ^{[18
]}

Tudini, Marianna ^{[19
]}

Fratino, Lucia ^{[20
]}

Prati, Veronica ^{[21
]}

Caffo, Orazio ^{[22
]}

Atzori, Francesco ^{[23
]}

Morelli, Franco ^{[24
]}

Prati, Giuseppe ^{[25
,26
]}

Nole, Franco ^{[27
]}

Vignani, Francesca ^{[28
]}

Cavo, Alessia ^{[29
]}

Di Napoli, Marilena ^{[30
]}

Malgeri, Andrea ^{[31
]}

Naglieri, Emanuele ^{[32
]}

Signori, Alessio ^{[33
]}

Banna, Giuseppe Luigi ^{[34
]}

Rescigno, Pasquale ^{[35
]}

Cerbone, Linda ^{[36
]}

Antonuzzo, Lorenzo ^{[37
,38
]}

Roviello, Giandomenico ^{[1
]}

机构：

[1] Univ Firenze, Dept Hlth Sci, Sect Clin Pharmacol & Oncol, Florence, Italy

[2] Osped San Paolo, Med Oncol Unit, Savona, Italy

[3] Univ Genoa, Dept Internal Med & Med Specialties DiMI, Genoa, Italy

[4] IRCCS, Ist Oncol Veneto IOV, Dept Oncol, Oncol Unit 1, Padua, Italy

[5] IRCCS, Ist Romagnolo Studio Tumori IRST Dino Amadori, Dept Med Oncol, Meldola, Italy

[6] Univ Parma, Dept Med & Surg, Parma, Italy

[7] Univ Hosp Parma, Med Oncol Unit, Parma, Italy

[8] Azienda Osped Univ Pisana, Unit Med Oncol 2, Pisa, Italy

[9] IRCCS Osped Policlin San Martino Genova, Med Oncol Unit 1, Milan, Italy

[10] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[11] IRCCS Humanitas Res Hosp, Dept Oncol, Milan, Italy

[12] Fdn IRCCS Ist Nazl Tumori, SS Oncol Med Genitourinaria, Milan, Italy

[13] IRCCS Policlin San Matteo, Med Oncol Unit, Pavia, Italy

[14] Univ Verona, Dept Engn Innovat Med DIMI, Sect Innovat Biomed, Oncol Area, Verona, Italy

[15] Univ Hosp Modena, Dept Oncol & Hematol, Med Oncol Unit, Modena, Italy

[16] IRCCS MultiMed, Oncol Unit, AULSS 6 Euganea, Milan, Italy

[17] Osped Camposampiero, UOC Oncol, Cardiol Unit, Padua, Italy

[18] IRCCS Azienda Osped Univ Bologna, Med Oncol, Bologna, Italy

[19] St Salvatore Hosp, Med Oncol, Laquila, Italy

[20] IRCCS, Ctr Riferimento Oncol Aviano CRO, Dept Med Oncol, Aviano, Italy

[21] Michele & Pietro Ferrero Hosp, Gen Med, COVID 19 Isolat Unit, Verduno, Italy

[22] Santa Chiara Hosp, Dept Med Oncol, Trento, Italy

[23] Azienda Sanitaria Locale ASL Sulcis, SSD Oncol Med, Cagliari, Italy

[24] IRCCS, Med Oncol Dept, Casa Sollievo Della Sofferenza Hosp, San Giovanni Rotondo, Italy

[25] IRCCS Reggio Emilia, Dept Oncol, Reggio Emilia, Italy

[26] IRCCS Reggio Emilia, Adv Technol AUSL, Reggio Emilia, Italy

[27] European Inst Oncol IRCCS, Med Oncol Div Urogenital & Head & Neck Tumors, IEO, Milan, Italy

[28] Mauriziano Hosp, Div Med Oncol, Turin, Italy

[29] Villa Scassi Hosp, Oncol Unit, Genoa, Italy

[30] Ist Nazl Tumori IRCCS Fdn G Pascale, Dept Urol & Gynecol, I-80138 Naples, Italy

[31] Fdn Policlin Campus Biomed, Dept Med Oncol, Rome, Italy

[32] IRCCS Ist Tumori Giovanni Paolo II, Expt Med Oncol, Bari, Italy

[33] Univ Genoa, Dept Hlth Sci, Sect Biostat, Genoa, Italy

[34] Univ Portsmouth, Fac Sci & Hlth, Sch Pharm & Biomed Sci, Portsmouth Hosp Univ NHS Trust, Portsmouth, England

[35] FPO IRCCS, Candiolo Canc Inst, Turin, Italy

[36] San Camillo Forlanini Hosp, Dept Med Oncol, Rome, Italy

[37] Careggi Univ Hosp, Clin Oncol Unit, Florence, Italy

[38] Univ Florence, Dept Expt & Clin Med, Florence, Italy

来源：

FRONTIERS IN IMMUNOLOGY | 2024年 / 15卷

关键词：

renal cell carcinoma; bone metastases; immunotherapy; sodium levels; efficacy outcomes; RENAL-CELL CARCINOMA; CANCER PATIENTS; HYPONATREMIA; NIVOLUMAB; ASSOCIATION; EVEROLIMUS; THERAPY;

D O I：

10.3389/fimmu.2024.1361010

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background Immune-checkpoint inhibitors (ICIs) have significantly improved metastatic renal cell carcinoma (mRCC) prognosis, although their efficacy in patients with bone metastases (BMs) remains poorly understood. We investigated the prognostic role of natremia in pretreated RCC patients with BMs receiving immunotherapy. Materials and methods This retrospective multicenter study included RCC patients with BMs receiving nivolumab as second-line therapy or beyond. Inclusion criteria involved baseline sodium levels (pre-ICI) and sodium levels after 4 weeks of nivolumab initiation (post-ICI). The population was divided into two groups based on the median value, and response rates, progression-free survival (PFS), and overall survival (OS) were assessed. Results Among 120 eligible patients, those with pre-treatment sodium levels >= 140 mEq/L showed longer OS (18.7 vs. 12.0 months, p=0.04). Pre-treatment sodium levels >= 140 mEq/L were associated with better OS compared to levels <140 mE/L (18.7 vs. 12.0, p=0.04). Post-treatment sodium levels >= 140 mEq/L were associated with improved PFS (9.6 vs. 3.2 months) and OS (25.1 vs. 8.8 months) (p=0.05 and p<0.01, respectively). Patients with consistent sodium levels >= 140 mEq/L at both time points exhibited the best outcomes compared to those with lower values (PFS 11.5 vs. 3.3 months and OS 42.2 vs. 9.0 months, respectively, p<0.01). Disease control rate was significantly higher in the latter group (p<0.01). Multivariate analysis confirmed the prognostic significance of sodium levels. Conclusion Elevated sodium levels (>= 140 mEq/L) pre- and post-ICI treatment correlate with better survival outcomes in mRCC patients with BMs. This finding suggests sodium level assessment as a potential prognostic factor in these patients and warrants further investigation, particularly in combination immunotherapy settings.

引用

页数：11

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