Hematological prognosticators in metastatic renal cell cancer treated with immune checkpoint inhibitors: A meta-analysis

Takafumi Yanagisawa, Keiichiro Mori, Satoshi Katayama, Hadi Mostafaei, Fahad Quhal, Ekaterina Laukhtina, Pawel Rajwa, Reza S. Motlagh, Abdulmajeed Aydh, Frederik König, Nico C. Grossmann, Benjamin Pradere, Jun Miki, Manuela Schmidinger, Shin Egawa, Shahrokh F. Shariat

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)


Aim: We aimed to assess the prognostic value of pretreatment hematological biomarkers in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors (ICIs). Methods: PubMed, Web of Science and Scopus databases were searched for articles according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: Fifteen studies comprising 1530 patients were eligible for meta-analysis. High levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein and lactate dehydrogenase were significantly associated with worse progression-free survival. High NLR and PLR were significantly associated with worse overall survival. Conclusion: High pretreatment NLR and PLR appear to be hematological prognostic factors of progression and overall mortality in mRCC patients treated with ICIs. These findings might help in the design of correlative biomarker studies to guide the clinical decision-making in the immune checkpoint inhibitor era. Plain language summary Identifying the predictive/prognostic factors that can be applied to daily clinical practice is mandatory to facilitate the use of immune checkpoint inhibitors. Some pretreatment hematological markers used in daily clinical practice appear to be prognostic factors in metastatic renal cell carcinoma patients treated with immune checkpoint inhibitors. We believe that the findings of the present meta-analysis might help researchers to design prospective correlative biomarker studies to guide clinical decision-making in the immunotherapy era.

Original languageEnglish
Pages (from-to)709-725
Number of pages17
Issue number9
Publication statusPublished - Jun 2022


  • C-reactive protein
  • immune checkpoint inhibitor
  • lactate dehydrogenase
  • meta-analysis
  • metastatic renal cell carcinoma
  • neutrophil-to-lymphocyte ratio
  • nivolumab
  • PD-1
  • platelet-to-lymphocyte ratio
  • prognostic factor

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Oncology


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