C-reactive protein and immune-related adverse events as prognostic biomarkers in immune checkpoint inhibitor treated metastatic renal cell carcinoma patients

Figures & data

Table 1. Frequency of immune related adverse events.

	Grade 1-2 N = 26 (27.1%)	Grade 3-4 N = 10 (10.1%)	Total N = 56 (58,5%)
Cutaneous	14 (14.6)	1 (1.0)	14 (14.6)
Pneumonitis	8 (8.4)	1 (1.0)	9 (9.4)
Diarrhea/colitis	4 (4.2)	3 (3.1)	7 (7.3)
Hepatic	6 (6.3)	1 (1.0)	6 (6.3)
Endocrinopathies	7 (7.3)		6 (6.3)
Pancreatitis	3 (3.1)	1 (1.0)	4 (4.2)
Arthritis	2 (2.1)		2 (2.1)
Cardiac toxicity	1 (1.0)	1 (1.0)	2 (2.1)
Neurological toxicity	1 (1.0)	1 (1.0)	2 (2.1)
Stomatitis	2 (2.1)		2 (2.1)
Gastritis		1 (1.0)	1 (1.0)

Table 2. Patients’ characteristics overall and by baseline CRP status.

		Baseline CRP
		≤10mmol/L N = 54 (56,3%)	>10mmol/L N = 42 (43,8%)	Total N = 96
Gender	Male	29 (53,7)	33 (78,6)	62 (64,6) p = .011
	Female	25 (46,3)	9 (21,4)	34 (35,4)
Age	Median	68.0	64.0	65.0
	Range	36-82	22-82	22-82
Karnofsky < 80%	Yes	1 (1,9)	3 (7,1)	4 (4,2) p = .198
	No	53 (98,1)	39 (92,9)	93 (95,8)
Prior nephrectomy	Yes	48 (88,9)	35 (83,3)	83 (86,5) p = .430
	No	6 (11,1)	7 (16,7)	13 (13,5)
Histology	Clear cell	53 (98,1)	36 (90,0)	89 (94,7) p = .082
	Non clear cell	1 (1,9)	4 (10,0)	5 (5,3)
	Missing	2	0	2
IMDC classification	Favorable	8 (14.8)	2 (4,8)	10 (10,4) p = .000
	Intermediate	41 (75,9)	19 (45,2)	60 (62,5)
	Poor	5 (9,3)	21 (50,0)	26 (27,1)

CRP: C-reactive protein; IMDC: all International Metastatic Database Consortium.

Figure 1. Overall survival (a) and progression-free survival (b) for baseline CRP.

Figure 2. Overall survival (a) and progression-free survival (b) for irAEs.

Table 3. Multivariate survival analysis.

	Overall Survival		Progression-free Survival
	adjusted HR	95%CI	adjusted HR	95%CI
(A)
Age > 65 IMDC classification	1.42	0.81–2.48	1.04	0.66–1.65
Intermediate	7.22	1.00–53.27	0.84	0.39–1.79
Poor	8.65	1.13–66.29	1.06	0.45–2.49
Baseline CRP	2.84	1.48–5.42	1.77	1.06–2.97
(B)
Age > 65 IMDC classification	1.52	0.87–2.65	1.10	0.69–1.75
Intermediate	6.45	0.87–47.64	0.77	0.36–1.66
Poor	8.67	1.13–66.32	1.01	0.43–2.33
On-treatment CRP	3.68	1.92–7.03	2.88	1.75–4.73
(C)
Age > 65 IMDC classification	1.27	0.73–2.21	0.97	0.62–1.52
Intermediate	9.36	1.25–69.93	1.05	0.48–2.28
Poor	15.51	2.07–16.26	1.53	0.68–3.44
Immune related adverse event during treatment	1.93	1.03–3.62	1.55	0.95–2.55

CRP: C-reactive protein; IMDC: all International Metastatic Database Consortium; HR: hazard ratio; CI: confidence interval.

Data availability statement

The data that support the findings of this study are available from the corresponding author, E. Kankkunen, upon reasonable request.