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Purpose <p>The purpose of this study is to determine the utility of the CANLPH score as a predictive biomarker for patients with advanced and metastatic renal cell carcinoma (a/mRCC). By validating its prognostic value, this study aims to contribute to more personalized treatment strategies for a/mRCC.</p> Methods <p>In a multicenter retrospective study by the JK-FOOT consortium, we analyzed data from 309 a/mRCC patients undergoing ICI-based therapy. The CANLPH score—a composite marker of C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), and platelet to hemoglobin ratio (PHR)—for its prognostic accuracy in predicting cancer-specific survival (CSS). Advanced statistical methods, including receiver operating characteristic (ROC) curve analysis, Cox proportional-hazard regression, and Harrell’s concordance index (C-index), were employed to assess its predictive capacity against established factors.</p> Results <p>The median follow-up period was 17 months, revealing two-year and five-year overall survival rates of 76.8% and 62.4%, respectively, with CSS rates at 78.3% and 66.2%. The CANLPH score well stratified survival outcomes of ICI-based treatment for RCC patients (HR 5.71; P &lt; 0.0001). C-index analysis demonstrated that the CANLPH score had the highest predictive potency for CSS among models, including IMDC score. Multivariate analysis confirmed the CANLPH score (HR, 5.59; P = 0.0007) and Karnofsky performance status (HR, 2.59; P = 0.0032) as independent prognostic factors for CSS.</p> Conclusions <p>The CANLPH score emerges as a critical tool in the a/mRCC therapeutic landscape, enabling precise prediction of patient outcomes with ICI-based therapies. Limitations include the retrospective design and the single national cohort. Prospective validation studies are warranted.</p>

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Deciphering RCC immunotherapy outcomes: insights from a Japanese multi-institutional study on the CANLPH score’s impact

  • 期刊论文

  • 发表日期：

    2025年2月24日

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  • Tatsuo Fukushima,
  • Takuya Tsujino,
  • Moritoshi Sakamoto,
  • Kiyoshi Takahara,
  • Kazumasa Komura,
  • Takafumi Yanagisawa,
  • Keiichiro Mori,
  • Wataru Fukuokaya,
  • Fumihiko Urabe,
  • Takahiro Adachi,
  • Yosuke Hirasawa,
  • Masanobu Saruta,
  • Atsuhiko Yoshizawa,
  • Shingo Toyoda,
  • Tatsushi Kawada,
  • Satoshi Katayama,
  • Kengo Iwatsuki,
  • Ko Nakamura,
  • Kyosuke Nishio,
  • Kazuki Nishimura,
  • Keita Nakamori,
  • Tomohisa Matsunaga,
  • Ryoichi Maenosono,
  • Taizo Uchimoto,
  • Tomoaki Takai,
  • Takeshi Hashimoto,
  • Teruo Inamoto,
  • Kazutoshi Fujita,
  • Motoo Araki,
  • Takahiro Kimura,
  • Yoshio Ohno,
  • Ryoichi Shiroki,
  • Haruhito Azuma

摘要

Purpose

The purpose of this study is to determine the utility of the CANLPH score as a predictive biomarker for patients with advanced and metastatic renal cell carcinoma (a/mRCC). By validating its prognostic value, this study aims to contribute to more personalized treatment strategies for a/mRCC.

Methods

In a multicenter retrospective study by the JK-FOOT consortium, we analyzed data from 309 a/mRCC patients undergoing ICI-based therapy. The CANLPH score—a composite marker of C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), and platelet to hemoglobin ratio (PHR)—for its prognostic accuracy in predicting cancer-specific survival (CSS). Advanced statistical methods, including receiver operating characteristic (ROC) curve analysis, Cox proportional-hazard regression, and Harrell’s concordance index (C-index), were employed to assess its predictive capacity against established factors.

Results

The median follow-up period was 17 months, revealing two-year and five-year overall survival rates of 76.8% and 62.4%, respectively, with CSS rates at 78.3% and 66.2%. The CANLPH score well stratified survival outcomes of ICI-based treatment for RCC patients (HR 5.71; P < 0.0001). C-index analysis demonstrated that the CANLPH score had the highest predictive potency for CSS among models, including IMDC score. Multivariate analysis confirmed the CANLPH score (HR, 5.59; P = 0.0007) and Karnofsky performance status (HR, 2.59; P = 0.0032) as independent prognostic factors for CSS.

Conclusions

The CANLPH score emerges as a critical tool in the a/mRCC therapeutic landscape, enabling precise prediction of patient outcomes with ICI-based therapies. Limitations include the retrospective design and the single national cohort. Prospective validation studies are warranted.