Reassessing prognostic markers in metastatic renal cell carcinoma in the era of immune checkpoint inhibitors: the enduring value of body composition, nutritional, and inflammatory indices.

Low visceral adipose tissue index (VATI) was associated with shorter overall survival in metastatic renal cell carcinoma patients.

• HR 1.64, P = 0.030 in the overall cohort of 136 mRCC patients
• VATI is a body composition index assessed from imaging data
• Association was evaluated across patients receiving both non-ICI-based and ICI-based regimens as first-line therapy
• Analysis was retrospective

Low subcutaneous adipose tissue index (SATI) was associated with shorter overall survival in metastatic renal cell carcinoma patients.

• HR 2.22, P < 0.001 in the overall cohort
• In the ICI-based regimen group, SATI demonstrated a C-index of 0.690
• SATI provided clear OS stratification in the ICI-based regimen group
• SATI showed higher prognostic performance in the ICI-based subgroup compared to the overall cohort analysis

The Prognostic Nutritional Index (PNI) showed strong prognostic value for overall survival in mRCC patients.

• HR 1.70, P < 0.001 in the overall cohort
• In the ICI-based regimen group, PNI demonstrated the highest C-index among assessed markers at 0.736
• PNI provided clear OS stratification in the ICI-based regimen group
• PNI was among the indices with higher prognostic performance specifically in ICI-treated patients

The Geriatric Nutritional Risk Index (GNRI) showed strong prognostic value for overall survival in mRCC patients.

• HR 1.57, P < 0.001 in the overall cohort
• In the ICI-based regimen group, GNRI demonstrated a C-index of 0.730
• GNRI was identified as one of the higher-performing prognostic indices in the ICI-based subgroup
• GNRI is a nutritional marker assessed alongside PNI in this cohort of 136 patients

The Glasgow Prognostic Score (GPS) was associated with shorter overall survival in mRCC patients.

• HR 2.43, P < 0.001 in the overall cohort of 136 patients
• GPS had the highest hazard ratio among the inflammatory markers assessed
• GPS is an inflammatory marker evaluated alongside SII and other indices
• The study compared prognostic impact between non-ICI-based and ICI-based first-line therapy groups

The Systemic Inflammatory Index (SII) was associated with shorter overall survival in mRCC patients.

• HR 2.11, P < 0.001 in the overall cohort
• SII was evaluated as one of several inflammatory markers in 136 mRCC patients
• The study included both patients treated with non-ICI-based and ICI-based regimens as first-line therapy
• SII is described alongside GPS as part of the inflammatory indices assessed

Skeletal muscle index (SMI) was assessed but did not demonstrate equivalent prognostic significance compared to adipose tissue indices in the overall cohort.

• SMI was one of three body composition indices evaluated alongside VATI and SATI
• The abstract highlights low VATI (HR 1.64, P = 0.030) and low SATI (HR 2.22, P < 0.001) as significantly associated with survival, but does not report a significant HR for SMI
• Study population comprised 136 mRCC patients treated with systemic therapy
• The study was retrospective in design

Many risk factors identified during the tyrosine kinase inhibitor era remain unvalidated in the context of ICI-based first-line therapy for mRCC.

• ICIs are now the standard first-line treatment for metastatic renal cell carcinoma
• The study aimed to evaluate the prognostic value of body composition, nutritional, and inflammatory indices specifically in the era of ICI-based first-line therapy
• 136 mRCC patients were retrospectively analyzed, with subgroup comparisons between non-ICI-based and ICI-based first-line regimen recipients
• The study addresses a gap in validation of prognostic markers under current standard-of-care treatment