Clinical laboratory tests associated with survival in patients with metastatic renal cell carcinoma: A Laboratory Wide Association Study (LWAS)

Velaer, Kyla N.; Thomas, I‐Chun; Yang, Jaden; Kapphahn, Kristopher; Metzner, Thomas J.; Golla, Abhinav; Hoerner, Christian R.; Fan, Alice C.; Master, Viraj A.; Chertow, Glenn M.; Brooks, James D.; Patel, Chirag; Desai, Manisha; Leppert, John T.

doi:10.1016/j.urolonc.2021.08.011

Cited by 3 publications

(3 citation statements)

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“…Prediction of response to treatment and counselling regarding patients’ prognosis remains a challenge. Thus, the identification of clinical and laboratory features endowed with prognostic or predictive potential in daily practice might significantly improve patient management [ 8 – 10 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

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External validation of a red cell-based blood prognostic score in patients with metastatic renal cell carcinoma treated with first-line immunotherapy combinations

Maffezzoli,

Santoni,

Mazzaschi

et al. 2024

Clin Exp Metastasis

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Immunotherapy combinations with tyrosine-kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) had significantly improved outcomes of patients with mRCC. Predictive and prognostic factors are crucial to improve patients’ counseling and management. The present study aimed to externally validate the prognostic value of a previously developed red cell-based score, including hemoglobin (Hb), mean corpuscular volume (MCV) and red cell distribution width (RDW), in patients with mRCC treated with first-line immunotherapy combinations (TKI plus ICI or ICI plus ICI). We performed a sub-analysis of a multicentre retrospective observational study (ARON-1 project) involving patients with mRCC treated with first-line immunotherapy combinations. Uni- and multivariable Cox regression models were used to assess the correlation between the red cell-based score and progression-free survival (PFS), and overall survival (OS). Logistic regression were used to estimate the correlation between the score and the objective response rate (ORR). The prognostic impact of the red cell-based score on PFS and OS was confirmed in the whole population regardless of the immunotherapy combination used [median PFS (mPFS): 17.4 vs 8.2 months, HR 0.66, 95% CI 0.47–0.94; median OS (mOS): 42.0 vs 17.3 months, HR 0.60, 95% CI 0.39–0.92; p < 0.001 for both]. We validated the prognostic significance of the red cell-based score in patients with mRCC treated with first-line immunotherapy combinations. The score is easy to use in daily clinical practice and it might improve patient counselling.

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Section: Discussionmentioning

confidence: 99%

“…Despite these therapeutic advances, predictive and prognostic factors are largely lacking. Reliable biomarkers based on the underlying disease mechanisms and drugs pharmacodynamics should ideally guide clinical decision making to select the appropriate combination [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

External validation of a red cell-based blood prognostic score in patients with metastatic renal cell carcinoma treated with first-line immunotherapy combinations

Maffezzoli,

Santoni,

Mazzaschi

et al. 2024

Clin Exp Metastasis

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“…Similarly, the WWAS framework allows for a rigorous analysis of many environmental exposures and a single outcome. We have previously applied XWAS to study associations between routinely collected laboratory tests and survival in veterans with prostate cancer 42 and metastatic kidney cancer 43 . Using WWAS, we used a large data set of incident kidney cancer cases and incidence on a county level in California in three 5‐year cohorts—that should increase reproducibility and decrease false discovery.…”

Section: Discussionmentioning

confidence: 99%

Groundwater constituents and the incidence of kidney cancer

Soerensen

Montez‐Rath

Cheng

et al. 2023

Cancer

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BackgroundKidney cancer incidence demonstrates significant geographic variation suggesting a role for environmental risk factors. This study sought to evaluate associations between groundwater exposures and kidney cancer incidence.MethodsThe authors identified constituents from 18,506 public groundwater wells in all 58 California counties measured in 1996–2010, and obtained county‐level kidney cancer incidence data from the California Cancer Registry for 2003–2017. The authors developed a water‐wide association study (WWAS) platform using XWAS methodology. Three cohorts were created with 5 years of groundwater measurements and 5‐year kidney cancer incidence data. The authors fit Poisson regression models in each cohort to estimate the association between county‐level average constituent concentrations and kidney cancer, adjusting for known risk factors: sex, obesity, smoking prevalence, and socioeconomic status at the county level.ResultsThirteen groundwater constituents met stringent WWAS criteria (a false discovery rate <0.10 in the first cohort, followed by p values <.05 in subsequent cohorts) and were associated with kidney cancer incidence. The seven constituents directly related to kidney cancer incidence (and corresponding standardized incidence ratios) were chlordane (1.06; 95% confidence interval [CI], 1.02–1.10), dieldrin (1.04; 95% CI, 1.01–1.07), 1,2‐dichloropropane (1.04; 95% CI, 1.02–1.05), 2,4,5‐TP (1.03; 95% CI, 1.01–1.05), glyphosate (1.02; 95% CI, 1.01–1.04), endothall (1.02; 95% CI, 1.01–1.03), and carbaryl (1.02; 95% CI, 1.01–1.03). Among the six constituents inversely related to kidney cancer incidence, the standardized incidence ratio furthest from the null was for bromide (0.97; 95% CI, 0.94–0.99).ConclusionsThis study identified several groundwater constituents associated with kidney cancer. Public health efforts to reduce the burden of kidney cancer should consider groundwater constituents as environmental exposures that may be associated with the incidence of kidney cancer.

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External Validation of a Red Cell-based Blood Prognostic Score in Patients With Metastatic Renal Cell Carcinoma Treated With First- Line Immunotherapy Combinations

MAFFEZZOLI,

SANTONI,

MAZZASCHI

et al. 2023

Preprint

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Introduction Immunotherapy combinations with tyrosine-kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) had significantly improved outcomes of patients with mRCC. Predictive and prognostic factors are crucial to improve patients' counseling and management. The present study aimed to externally validate the prognostic value of a previously developed red cell-based score, including hemoglobin (Hb), mean corpuscular volume (MCV) and red cell distribution width (RDW), in patients with mRCC treated with first-line immunotherapy combinations (TKI plus ICI or ICI plus ICI). Materials and methods We performed a sub-analysis of a multicentre retrospective observational study (ARON-1 project) involving patients with mRCC treated with first-line immunotherapy combinations. Uni- and multivariable Cox regression models were used to assess the correlation between the red cell-based score and progression-free survival (PFS), and overall survival (OS). Logistic regression were used to estimate the correlation between the score and the objective response rate (ORR). Results. The prognostic impact of the red cell-based score on PFS and OS was confirmed in the whole population regardless of the immunotherapy combination used [median PFS (mPFS): 17.4 vs 8.2 months, HR 0.66, 95% CI 0.47–0.94; median OS (mOS): 42.0 vs 17.3 months, HR 0.60, 95%CI 0.39–0.92; p < 0.001 for both]. Conclusion. We validated the prognostic significance of the red cell-based score in patients with mRCC treated with first-line immunotherapy combinations. The score is easy to use in daily clinical practice and it might improve patient counselling.

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Clinical laboratory tests associated with survival in patients with metastatic renal cell carcinoma: A Laboratory Wide Association Study (LWAS)

Cited by 3 publications

References 31 publications

External validation of a red cell-based blood prognostic score in patients with metastatic renal cell carcinoma treated with first-line immunotherapy combinations

External validation of a red cell-based blood prognostic score in patients with metastatic renal cell carcinoma treated with first-line immunotherapy combinations

Groundwater constituents and the incidence of kidney cancer

External Validation of a Red Cell-based Blood Prognostic Score in Patients With Metastatic Renal Cell Carcinoma Treated With First- Line Immunotherapy Combinations

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