Abstract
Objective
Immunotherapy-tyrosine kinase inhibitor (IO-TKI) therapy has revolutionized the treatment landscape for metastatic clear cell renal cell carcinoma (mccRCC); however, the absence of effective biomarkers poses a challenge in predicting the efficacy of these regimens. This study aims to explore the predictive and prognostic value of serum immunoglobulin A (IgA) in mccRCC patients undergoing IO-TKI therapy.
Methods
Ninety-six mccRCC patients treated with IO-TKI therapy from 2019 to 2023 were enrolled and serum IgA levels were assessed at the pretreatment baseline and after 3 months of treatment.
Results
Notably, baseline levels of IgA showed no correlation with the objective response rate. However, patients achieving complete or partial responses exhibited a remarkable decrease in IgA levels, while those with stable or progressive disease displayed an increase in IgA levels after 3 months of treatment. Furthermore, the dynamic alteration in IgA levels after 3 months of treatment demonstrated predictive value for both progression-free survival (PFS) and overall survival (OS). The time-dependent receiver operating characteristic curves exhibited outstanding performance in predicting PFS (AUC 0.793) and OS (AUC 0.738).
Conclusion
Taken together, this study demonstrates that dynamic alteration of serum IgA after 3 months of treatment was significantly correlated with prognosis and therapeutic efficacy in mccRCC patients.
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Data availability
The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.
References
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Acknowledgement
We thank **aoyan Qiu and Weiyan Xu from the Department of Immunology, School of Basic Medical Sciences, Peking University, Bei**g, for their support.
Funding
This work was financially supported by the National Natural Science Foundation of China (ID Number: 82072837).
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JZS had full access to all the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: JZS, APZ. Acquisition of data: HLC, JW. Analysis and interpretation of data: HLC, JW. Drafting of the manuscript: JZS, HLC, JW. Critical revision of the manuscript for important intellectual content: GD, YYG, HZS. Obtaining funding: JZS. Supervision: JZS, APZ. Other: None.
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Disclosure
Hong-Lei Cui, Jie Wu, Gan Du, You-Yan Guan, Hong-Zhe Shi, Ai-** Zhou, Jian-Zhong Shou declare no conflicts of interest that may be relevant to the contents of this manuscript.
Ethics approval
This study was approved by the institutional Ethics Committee of the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (approval number: 20/245-2441).
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Cui, HL., Wu, J., Du, G. et al. Serum IgA as a Prognostic Beacon: Anticipating Systemic Therapy Efficacy in Metastatic Clear Cell Renal Cell Carcinoma. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15448-w
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DOI: https://doi.org/10.1245/s10434-024-15448-w