Baseline and early changes in eosinophil count and neutrophil-to-eosinophil ratio predict outcomes in metastatic renal cell carcinoma treated with nivolumab

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Authors	FIALA Ondrej REJLEKOVA Katarina BUCHLER Tomas STUDENTOVA Hana POPRACH Alexandr VOCKA Michal HOSEK Petr KOPECKY Jindrich MATEJU Martin ZEMANKOVA Anezka SPISAROVA Martina TKADLECOVA Michaela PRIESTER Peter KOURIL Jan LOHYNSKA Radka GRMELOVA Lucie SAVKA Alexander STEFANIKOVA Katarina OBERTOVA Jana SIKOVA Dominika STRANSKY Petr MELICHAR Bohuslav PALACKA Patrik
Year of publication	2025
Type	Peer-reviewed scientific article
Magazine / Source	Nature Scientific Reports
MU Faculty or unit	Faculty of Medicine
Citation
web	https://www.nature.com/articles/s41598-025-32593-8
Doi	https://doi.org/10.1038/s41598-025-32593-8
Keywords	Renal cell carcinoma; Eosinophils; Neutrophil-to-eosinophil ratio; Immunotherapy; Nivolumab
Attached files	Baseline_and_early_changes_in_eosinophil_count_and_neutrophil-to-eosinophil_ratio_predict_outcomes_in_metastatic_renal_cell_carcinoma_treated_with_nivolumab.pdf
Description	The role of eosinophils in patients with cancer receiving systemic therapy based on immune checkpoint inhibitors (ICIs) has become a subject of increasing interest. The aim of the present study was to assess the prognostic role of absolute eosinophil count (AEC) and neutrophil-to-eosinophil ratio (NER) in patients with metastatic renal cell carcinoma (mRCC) receiving nivolumab. The associations of AEC and NER at baseline and their relative changes (Delta) after one month of nivolumab therapy with progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) were analyzed. In total, 458 patients were included. Baseline AEC >= 70 cells/mu L (PFS: HR: 0.663, p = 0.009; OS: HR: 0.583, p = 0.002), AEC one month after nivolumab initiation >= 70 cells/mu L (PFS: HR: 0.544, p = 0.001; OS: HR: 0.331, p < 0.001) and NER < 65 one month after nivolumab initiation (PFS: HR: 0.552, p < 0.001; OS: HR: 0.326, p < 0.001) was associated with superior PFS and OS, and baseline NER < 65 was associated with superior OS (HR: 0.664, p = 0.014). Regarding early dynamics, Delta NER >= 125% was associated with inferior PFS (HR: 1.950, p = 0.001) and OS (HR: 2.680, p < 0.001), and Delta AEC <-30% was associated with inferior OS (HR: 2.132, p < 0.001). Higher ORR was associated with baseline AEC >= 70 cells/mu L (p = 0.048), baseline NER < 65 (p = 0.010); and NER one month after nivolumab initiation < 65 (p = 0.025). The results of the present study suggest that eosinophil-based blood parameters including AEC and NER and their early dynamics during the course of treatment with nivolumab are promising and readily available prognostic biomarkers in patients with mRCC.
Related projects:	National institute for cancer research