38 Prognostic Nutritional Index as a Predictor of Outcomes with Immune Checkpoint Inhibitors in Renal Cell Carcinoma

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A high Prognostic Nutritional Index (PNI) prior to treatment is associated with improved overall survival, and a high PNI after 30 days predicts improved time-to-treatment failure in patients with metastatic renal cell carcinoma receiving immune checkpoint inhibitors. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Kashyap Koul; Ardit Feinaj; Jiazhang Xing; Kemuel Clarke; Mark Markowski; Yasser Ged

doi:10.1093/oncolo/oyag312.039

September 1, 2026The OncologistOpen Access

38 Prognostic Nutritional Index as a Predictor of Outcomes with Immune Checkpoint Inhibitors in Renal Cell Carcinoma

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Key Points

To evaluate the association between the Prognostic Nutritional Index and clinical outcomes in patients with metastatic renal cell carcinoma receiving immune checkpoint inhibitors.
Retrospective cohort analysis of N=289 patients with biopsy-proven metastatic renal cell carcinoma treated with immune checkpoint inhibitors at Sidney Kimmel Cancer Center.
Patients were stratified into low (<45) and high (≥45) Prognostic Nutritional Index (PNI) groups calculated at Day 0, Day 30, Day 60, and Day 90 post-treatment.
Univariate and multivariable analyses assessed overall survival and time-to-treatment failure across longitudinal timepoints.
Baseline high PNI was significantly associated with improved median overall survival compared to low PNI (47.96 months vs 19.71 months; HR 0.56, 95% CI: 0.41–0.76; p < 0.001), an effect sustained through Day 90 and on multivariable analysis.
Baseline PNI was not significantly associated with time-to-treatment failure (median 7.82 vs 9.20 months; HR 0.75, 95% CI: 0.56–1.02; p = 0.068), but high PNI at Day 30 significantly reduced failure risk (HR 0.63, 95% CI: 0.45–0.88; p = 0.007).

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Implication

Cohort study reveals higher prognostic nutritional index improves survival in metastatic renal cell carcinoma, indicating nutritional status predicts immunotherapy benefit.

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Koul et al. (2026) studied this question.

synapsesocial.com/papers/6a993643636c6408cfa7f470 https://doi.org/10.1093/oncolo/oyag312.039

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38 Prognostic Nutritional Index as a Predictor of Outcomes with Immune Checkpoint Inhibitors in Renal Cell Carcinoma

Key Points

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Cite This Study

38 Prognostic Nutritional Index as a Predictor of Outcomes with Immune Checkpoint Inhibitors in Renal Cell Carcinoma

Key Points

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Implication

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Cite This Study

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