Serum IgA as a Prognostic Beacon: Anticipating Systemic Therapy Efficacy in Metastatic Clear Cell Renal Cell Carcinoma

• Published in: Annals of surgical oncology Vol. 31; no. 8; pp. 4864 - 4867
• Main Authors: Cui, Hong-Lei, Wu, Jie, Du, Gan, Guan, You-Yan, Shi, Hong-Zhe, Zhou, Ai-Ping, Shou, Jian-Zhong
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2024; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; ASO Research Letter; Biomarkers, Tumor - blood; Carcinoma, Renal Cell - blood; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - secondary; Clear cell-type renal cell carcinoma; Female; Follow-Up Studies; Humans; Immunoglobulin A; Immunoglobulin A - blood; Immunotherapy; Immunotherapy - methods; Kidney cancer; Kidney Neoplasms - blood; Kidney Neoplasms - drug therapy; Kidney Neoplasms - pathology; Male; Medical prognosis; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Oncology; Prognosis; Protein Kinase Inhibitors - therapeutic use; Retrospective Studies; Surgery; Surgical Oncology; Survival Rate; Tyrosine kinase inhibitors; mccRCC; IgA; Immunotherapy-tyrosine kinase inhibitor
• DOI: 10.1245/s10434-024-15448-w
• ISSN: 1068-9265; 1534-4681

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.