A protein called γ-glutamyltransferase can predict survival in patients with local and metastatic renal cell carcinoma (RCC); however, in patients treated with immune checkpoint inhibitors, such as nivolumab, this predictive role is unknown. A study to be published in the International Journal of Clinical Oncology aimed to investigate the role of γ-glutamyltransferase as a predictive marker among metastatic RCC patients taking nivolumab.
There were 69 patients with metastatic RCC in the study who had been treated with nivolumab after the failure of one or more drugs. γ-glutamyltransferase levels were measured in the blood before treatment with nivolumab and again 2 months later. Patients were classified as high (≥ 49 U/L) and low (< 49 mg/dL) from baseline levels and the outcomes were compared between the two groups.
Overall survival was significantly shorter in the high baseline γ-glutamyltransferase group (20.3%) than in the low group (79.7%). Progression-free survival and overall survival were significantly shorter in the group of patients where γ-glutamyltransferase increased after 2 months than in the group where γ-glutamyltransferase did not increased (24.6% and 75.4%, respectively).
In conclusion, high baseline γ-glutamyltransferase and its early increase are associated with a poor prognosis in metastatic RCC patients receiving nivolumab. Serum γ-glutamyltransferase levels may help predict treatment outcomes.