In metastatic renal cell carcinoma (mRCC), immune checkpoint inhibitor treatment responses vary, which requires reliable prognostic biomarkers, according to the authors of a study published in Oncologist. For the study, Ziad El Bakouny, MD, and colleagues examined, in patients with mRCC treated with programmed death receptor-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors between 2012 and 2019, computed tomography (CT) texture analysis prognostic ability.

Predicting Overall & Progression-Free Survival in mRCC

In order to predict overall survival (OS) and progression-free survival (PFS), baseline and follow-up texture models were created using baseline and first follow-up. Dr. Bakouny and colleagues divided patients into high- or low-risk groups. They determined survival difference using Kaplan-Meier and log-rank tests.


Differentiating Shorter- & Longer-Term Survivors

The study team found that the baseline texture models differentiated longer- and shorter-term survivors for OS (median, 60.1 vs 17.0 months) and PFS (5.2 vs 2.8 months). They also observed that the follow-up texture models differentiated longer- and shorter-term OS (40.3 vs 15.2 months) but not PFS (5.0 vs 3.6 months). Finally, the combined clinical-texture model performed better than the clinical model in predicting PFS (C-index, 0.63 vs 0.55) and OS (C-index, 0.70 vs 0.63). “CT texture analysis performed at baseline and early after starting PD-1/PD-L1 inhibitors is associated with clinical outcomes of patients with mRCC,” the wrote Dr. Bakouny and colleagues.