Pd18-02 Neutrophil Extracellular Traps in Relationship to Efficacy of Systemic Therapy for Metastatic Renal Cell Carcinoma

You have accessJournal of UrologyKidney Cancer: Advanced (Including Drug Therapy) II (PD18)1 May 2024PD18-02 NEUTROPHIL EXTRACELLULAR TRAPS IN RELATIONSHIP TO EFFICACY OF SYSTEMIC THERAPY FOR METASTATIC RENAL CELL CARCINOMA Ruiyang Xie, Bingqing Shang, Hongzhe Shi, Xingang Bi, Shan Zheng, Jianming Ying, Aiping Zhou, Shudong Zhang, and Jianzhong Shou Ruiyang XieRuiyang Xie , Bingqing ShangBingqing Shang , Hongzhe ShiHongzhe Shi , Xingang BiXingang Bi , Shan ZhengShan Zheng , Jianming YingJianming Ying , Aiping ZhouAiping Zhou , Shudong ZhangShudong Zhang , and Jianzhong ShouJianzhong Shou View All Author Informationhttps://doi.org/10.1097/01.JU.0001008596.32809.c5.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The efficacy of systemic therapy regimens, such as immune checkpoint inhibitors and tyrosine kinase inhibitors (IO-TKI) and targeted therapy, for metastatic clear cell renal cell carcinoma (ccRCC) remains unpredictable due to the lack of effective biomarkers. This study investigates the predictive value of neutrophil extracellular traps (NETs) in determining the efficacy of metastatic ccRCC. METHODS: In this retrospective study, patients with metastatic ccRCC who received targeted drugs and IO-TKI were included. Immunofluorescence staining was utilized to quantify the levels of tissue NETs through cell counts of H3Cit(+) and MPO(+) cells. The predictive value of NETs for drug efficacy and prognosis was assessed. RESULTS: A total of 183 patients with metastatic ccRCC were enrolled, including 150 patients who received TKIs and 33 patients who received IO-TKI. H3Cit and MPO were predominantly expressed in the nucleus and cytoplasm, respectively. The levels of NETs in tumor tissue were significantly higher than in para-tumor tissue (p<0.001). In terms of predicting drug efficacy, a correlation between NETs levels and progression-free survival (PFS) was observed in the TKI with metachronous metastasis group (HR 1.73 95% CI 1.02-2.91, log-rank p=0.037), while no correlation was observed in the targeted agent with synchronous metastasis group and IO-TKI group. Regarding overall survival (OS), activated NETs levels were associated with poor OS (HR 1.87 95% CI 1.24-2.81, log-rank p=0.003). Cox analysis revealed that IMDC score (HR 1.462 95% CI 1.030-2.075, p=0.033) and tumor tissue NETs level (HR 1.733 95% CI 1.165-2.579, p=0.007) were independent prognostic risk factors for OS in patients with metastatic ccRCC. CONCLUSIONS: The active NETs level in tumor tissue can serve as a predictor of drug efficacy in patients with metastatic ccRCC who received targeted agents with metachronous metastasis. However, no significant correlation was observed in the IO-TKI group. Elevated levels of NETs in tumor tissue were also associated with poor prognosis in OS prediction. Source of Funding: This study is funded by the National Natural Science Foundation of China (ID: 82072837) and Beijing Municipal Natural Science Foundation (ID: 7212083) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e432 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ruiyang Xie More articles by this author Bingqing Shang More articles by this author Hongzhe Shi More articles by this author Xingang Bi More articles by this author Shan Zheng More articles by this author Jianming Ying More articles by this author Aiping Zhou More articles by this author Shudong Zhang More articles by this author Jianzhong Shou More articles by this author Expand All Advertisement PDF downloadLoading ...