https://orcid.org/0000-0001-6566-1430
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Abstract
Background
The Geriatric Nutritional Risk Index (GNRI) has been reported as a screening tool to assess the nutrition-related risk with mortality in older patients and those with the various diseases. However, the prognostic value of GNRI in metastatic renal cell carcinoma (mRCC) patients receiving nivolumab therapy remains unclear.
Methods
Fifty-six consecutive patients with mRCC receiving nivolumab between September 2013 and August 2020 at our institution were retrospectively analyzed. The survival outcomes and prognostic factors associated with overall survival (OS) were statistically analyzed.
Results
Thirteen and forty-three patients were classified with low (GNRI < 92) and high (GNRI ≥ 92) GNRI, respectively. Patients with low GNRI demonstrated significantly shorter OS (P = 0.0002) than those with high GNRI. In multivariate analysis, GNRI at the time of nivolumab (P = 0.008) was extracted as the predictor for OS in addition to Karnofsky performance status (KPS) (P = 0.016). Integration of the GNRI into the International Metastatic Renal Cell Cancer Database Consortium (IMDC) risk classification improved the c-index from 0.761 to 0.833 (combination of GNRI with IMDC risk classification) and to 0.778 (substitution of GNRI with KPS in IMDC risk classification).
Conclusions
GNRI was a significant prognostic biomarker in mRCC patients receiving nivolumab.
Author contributions
Conception and design: RF, TY, SY, administrative support: TY, JY, collection and assembly of data: RF, TY, data analysis and interpretation: RF, MF, KT, manuscript writing: RF. All authors final approval of manuscript.
Disclosure statement
T. Yuasa received remuneration for a lecture from Astellas (Tokyo, Japan), Sanofi Japan (Tokyo, Japan), Pfizer Japan (Tokyo, Japan), Novartis Pharma Japan (Tokyo, Japan), Ono Pharma (Osaka, Japan), Bristol-Myers Squibb Japan (Tokyo, Japan), Janssen Pharmaceutical K.K Japan (Tokyo, Japan), MSD Japan (Tokyo, Japan), and Daiichi-Sankyo (Tokyo, Japan). The other authors have declared no conflicts of interest.