Prognostic Significance of the Controlling Nutritional Status (CONUT) Score in Patients with Advanced Renal Cell Carcinoma Treated with Nivolumab after Failure of Prior Tyrosine Kinase Inhibitors

No AccessJournal of UrologyAdult Urology1 Dec 2020Prognostic Significance of the Controlling Nutritional Status (CONUT) Score in Patients with Advanced Renal Cell Carcinoma Treated with Nivolumab after Failure of Prior Tyrosine Kinase Inhibitors Kosuke Takemura, Takeshi Yuasa, Ryo Fujiwara, Masaya Ito, Hiroaki Suzuki, Junji Yonese, and Fumitaka Koga Kosuke TakemuraKosuke Takemura *Correspondence: Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital,3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8777, Japan telephone: +81-3-3823-2101; FAX: +81-3-3823-5433; E-mail Address: [email protected] Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan More articles by this author , Takeshi YuasaTakeshi Yuasa Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan More articles by this author , Ryo FujiwaraRyo Fujiwara Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan More articles by this author , Masaya ItoMasaya Ito Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan More articles by this author , Hiroaki SuzukiHiroaki Suzuki Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan More articles by this author , Junji YoneseJunji Yonese Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan More articles by this author , and Fumitaka KogaFumitaka Koga * E-mail Address: [email protected] Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001196AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The controlling nutritional status (CONUT) score, consisting of albumin, lymphocytes and total cholesterol, is a validated, objective tool for nutritional assessment. Patients with advanced cancer frequently have malnutrition in association with cachexia and chronic inflammation. We explored the prognostic significance of the CONUT score in patients with advanced renal cell carcinoma receiving nivolumab. Materials and Methods: This retrospective study included 60 patients with stage IV renal cell carcinoma treated with nivolumab after failure of prior tyrosine kinase inhibitors at 2 cancer centers between 2016 and 2019. Associations of the CONUT score with progression-free survival, cancer specific survival and tumor shrinkage rate were assessed. Results: The median (range) CONUT score was 2 (0-10). During followup periods 29 and 14 patients exhibited disease progression and died of cancer, respectively. Both progression-free survival and cancer specific survival were significantly stratified by CONUT scores of 0 to 1, 2 to 4 and 5 or more (p=0.002). A CONUT score of 5 or more (versus score 0 to 1) was independently associated with unfavorable progression-free survival (HR 5.18, p=0.003) and cancer specific survival (HR 15.34, p=0.014), as was the absence of prior nephrectomy (HR 4.23, p=0.004 and HR 6.57, p=0.001, respectively). C-indices of the CONUT score for predicting progression-free survival and cancer specific survival were 0.694 and 0.737, respectively. The CONUT score was significantly associated with the best response to nivolumab with the median tumor shrinkage rate of –23%, +8% and +24% for CONUT scores of 0 to 1, 2 to 4 and 5 or more, respectively (p=0.021). Conclusions: The CONUT score may be useful to predict the clinical outcomes and therapeutic response in patients with advanced renal cell carcinoma receiving nivolumab. References 1. : Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2019; 144: 1941. Google Scholar 2. : Epidemiology of renal cell carcinoma. 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Google Scholar The institutional review boards have approved the study protocol IRB Numbers 2416, 2019-1174. Written consent has been obtained from all participants for using their data for research purposes. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 204Issue 6December 2020Page: 1166-1172Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordsserologic testsmalnutritionnivolumabprognosiscarcinomarenal cellMetricsAuthor Information Kosuke Takemura Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan *Correspondence: Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital,3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8777, Japan telephone: +81-3-3823-2101; FAX: +81-3-3823-5433; E-mail Address: [email protected] More articles by this author Takeshi Yuasa Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan More articles by this author Ryo Fujiwara Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan More articles by this author Masaya Ito Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan More articles by this author Hiroaki Suzuki Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan More articles by this author Junji Yonese Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan More articles by this author Fumitaka Koga Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan * E-mail Address: [email protected] More articles by this author Expand All The institutional review boards have approved the study protocol IRB Numbers 2416, 2019-1174. Written consent has been obtained from all participants for using their data for research purposes. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Advertisement Loading ...