Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib

Abstract

BackgroundIn this retrospective analysis, we explored the prognostic and predictive value of the systemic immune-inflammation index (SII), based on lymphocyte, neutrophil, and platelet counts, at baseline and changes at week 6 during first-line sunitinib in patients with metastatic renal cell cancer (RCC).ResultsPatients were stratified into high SII (≥ 730) and low SII (< 730) groups. SII was associated with objective response, p < 0.0001. The median PFS was 6.3 months (95% CI 5.5–8.9) in patients with SII ≥ 730 and 18.7 months (95% CI 14.7–22.8) in those with SII < 730, p < 0.0001. The median OS was 43.6 months (95% CI 35.3–52.1) in patients with SII < 730, and 13.5 months (95% CI 9.8–18.5) in those with SII ≥ 730, p < 0.0001. In multivariate analysis, performance status, IMDC score and SII were able to predict OS (HR = 3.29, HR = 1.71 and HR = 1.79, respectively).Materials and MethodsWe included 335 consecutive RCC patients treated with first-line sunitinib. The X-tile 3.6.1 software (Yale University, New Haven, CT) was used for bioinformatic analysis of the data to determine the cutoff value of SII. Progression-free survival (PFS), overall survival (OS) and their 95% confidence interval (95% CI) were estimated by Kaplan-Meier method and compared with logrank test. The impact of SII conversion at week 6 of treatment on PFS and OS was evaluated by Cox regression analyses.ConclusionsThe SII and its changes during treatment represent a powerful prognostic indicator of clinical outcome in patients with metastatic RCC.

Association of Systemic Inflammation Index and Body Mass Index with Survival in Patients with Renal Cell Cancer Treated with Nivolumab

“…Thrombocytosis and lymphopenia have also been associated with prognosis in metastatic RCC treated with first-line VEGF-targeted treatment (11,12). Systemic immune inflammation index (SII) combines these three parameters: neutrophils, platelets, and lymphocytes, and has been previously significantly associated with prognosis in several tumor types including metastatic RCC (13)(14)(15).…”

Systemic immune-inflammation index in germ-cell tumours: search for a biological prognostic biomarker

“…The systemic immune-inflammation index (SII), which uses a simple calculation based on peripheral lymphocyte, neutrophil, and platelet counts, was recently investigated as a prognostic marker in several tumours (van Soest et al, 2015;Bhindi et al, 2016;Lolli et al, 2016). In this issue of the British Journal of Cancer, two articles highlight for the first time the prognostic significance of SII in patients with GCT.…”

The Interplay between Inflammation, Anti-Angiogenic Agents, and Immune Checkpoint Inhibitors: Perspectives for Renal Cell Cancer Treatment

“…In a recent retrospective series by Lolli et al, SII was identified as being a reliable parameter both as prognostic and predictive factor in RCC patients treated with sunitinib. Baseline SII values were independent factors for PFS and OS [114]. However, not all studies agree on the prognostic value of SII.…”