Systemic Inflammatory Markers Predicting the Overall Survival of Patients Using Tyrosine Kinase Inhibitors in the First-line Treatment of Metastatic Renal Cell Carcinoma

Objective: To identify prognostic inflammatory markers in metastatic renal cell carcinoma (mRCC) patients who received anti-vascular endothelial growth factor receptor (VEGFR) agents. Study Design: Observational study. Place and Duration of the Study: Department of Medical Oncology, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey, between January 2015 and December 2021. Methodology: A total of 110 patients with mRCC who received sunitinib or pazopanib for at least 3 months were enrolled. Hemogram, C-reactive protein (CRP) and albumin values of the patients, CRP to albumin ratio (CAR), neutrophil-lymphocyte ratio (NLR), platelet -lym-phocyte ratio (PLR), systemic immune-inflammation index (SII), prognostic nutrition index (PNI) and systemic inflammatory response indexes (SIRI) were calculated and recorded. Progression-free survival and overall survival analyses of the patients were performed using the Kaplan-Meier method. Cox regression method was used to identify prognostic factors. Variables found to be significant in univariate analysis were enrolled in multivariate analysis. Results: In the univariate analysis for median overall survival (mOS), whether or not surgery was applied as the primary treatment option, grade, lymphovascular invasion (LVI), International Metastatic RCC Database Consortium (IMDC) score, CAR, NLR, PLR, SII, PNI and SIRI were found to be statistically significant. Systemic inflammation markers (CAR, NLR, PLR, PNI, SII and SIRI) were found to be independent prognostic markers for mOS as a result of Cox multivariate analysis. Conclusion: CAR, NLR, PLR, SII, PNI, and SIRI values measured before anti-VEGFR treatment in patients with mRCC may be of addi-tional prognostic significance. These markers, which are calculated by using parameters that are always measured in routine practice, such as complete blood count (CBC), albumin, and CRP levels, are easy and inexpensive methods that give an idea about the course of the disease.