文章：

白蛋白与全身免疫炎症指数动态变化作为转移性肾细胞癌免疫检查点抑制剂治疗后卡博替尼治疗患者的预后标志物

Dynamic Changes in Albumin and Systemic Immune-Inflammation Index as Prognostic Markers in Patients Treated with Cabozantinib After Immune Checkpoint Inhibitors for Metastatic Renal Cell Carcinoma

原文发布日期：11 December 2025

DOI: 10.3390/cancers17243956

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: Cabozantinib is widely used as subsequent-line therapy after immune checkpoint inhibitor (ICI) treatment in metastatic renal cell carcinoma (mRCC), yet reliable on-treatment biomarkers are lacking. This study explored the prognostic value of a composite score combining early changes in serum albumin (ΔAlb) and the systemic immune–inflammation index (ΔSII) during cabozantinib therapy. Methods: We retrospectively analyzed 40 patients with mRCC who received cabozantinib after prior ICI therapy. Alb and SII were measured at baseline and 6 weeks after initiation. Patients were stratified into three categories according to the ΔAlb + ΔSII composite: both favorable, either unfavorable, or both unfavorable. Progression-free survival (PFS) was analyzed using Kaplan–Meier and Cox regression models. Results: Among 38 evaluable patients, PFS significantly differed across composite categories (pfor trend < 0.05). Patients with both favorable changes achieved notably longer PFS, while those with both unfavorable changes experienced the shortest. Compared with the both-favorable group, the “either” and “both unfavorable” groups had shorter PFS (HR = 1.83, 95% CI 0.61–5.46; HR = 6.27, 95% CI 1.61–24.49). Conclusions: In this small retrospective cohort, early on-treatment changes in Alb and SII showed an association with PFS in ICI-pretreated mRCC treated with cabozantinib. The ΔAlb + ΔSII composite may serve as a hypothesis-generating framework, warranting confirmation in larger, prospective studies.

摘要翻译： 

背景/目的：卡博替尼广泛用于转移性肾细胞癌（mRCC）免疫检查点抑制剂（ICI）治疗后的后续治疗，但目前缺乏可靠的治疗中生物标志物。本研究探讨了卡博替尼治疗期间血清白蛋白早期变化（ΔAlb）与全身免疫炎症指数早期变化（ΔSII）联合评分对预后的预测价值。方法：我们回顾性分析了40例既往接受过ICI治疗后使用卡博替尼治疗的mRCC患者。在基线及治疗开始后6周分别测量Alb和SII。根据ΔAlb + ΔSII联合评分将患者分为三类：两项均有利、任一项不利或两项均不利。采用Kaplan-Meier法和Cox回归模型分析无进展生存期（PFS）。结果：在38例可评估患者中，不同联合评分类别的PFS存在显著差异（趋势p值 < 0.05）。两项指标均呈有利变化的患者PFS显著更长，而两项均不利的患者PFS最短。与"两项均有利"组相比，"任一项不利"组和"两项均不利"组的PFS更短（HR = 1.83，95% CI 0.61–5.46；HR = 6.27，95% CI 1.61–24.49）。结论：在这项小型回顾性队列中，Alb和SII的早期治疗变化与卡博替尼治疗的ICI经治mRCC患者的PFS存在关联。ΔAlb + ΔSII联合评分可作为一个假设生成框架，值得在更大规模的前瞻性研究中加以验证。

原文链接：

Dynamic Changes in Albumin and Systemic Immune-Inflammation Index as Prognostic Markers in Patients Treated with Cabozantinib After Immune Checkpoint Inhibitors for Metastatic Renal Cell Carcinoma