C-Reactive Protein-Albumin Ratio Predicts Objective Response to Enfortumab Vedotin in Metastatic Urothelial Carcinoma

Taizo Uchimoto ¹, Takuya Matsuda ¹, Kazumasa Komura ^2,3

⁰Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.

Targeted Oncology +

|

May 28, 2024

View abstract on PubMed

Summary

The C-reactive protein-albumin ratio (CAR) in blood tests can predict how well patients with metastatic urothelial carcinoma respond to enfortumab vedotin (EV). A lower CAR indicates a better response to EV treatment.

Area Of Science

Oncology
Medical Diagnostics
Pharmacology

Background

Enfortumab vedotin (EV) is a key treatment for metastatic urothelial carcinoma post-chemotherapy and checkpoint inhibitors.
Predictive biomarkers for EV treatment response are currently limited.
Identifying reliable indicators is crucial for optimizing patient selection and treatment strategies.

Purpose Of The Study

To investigate the predictive value of peripheral blood test indicators for enfortumab vedotin (EV) treatment response.
To identify clinical indicators that correlate with objective responses in metastatic urothelial carcinoma patients.

Main Methods

Retrospective analysis of 109 metastatic urothelial carcinoma patients treated with EV.
Receiver operating characteristic (ROC) curve analysis to evaluate predictive performance of blood markers including C-reactive protein-albumin ratio (CAR), hemoglobin, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and lactate dehydrogenase.
Logistic regression analysis to identify independent predictors of objective response.

Main Results

The C-reactive protein-albumin ratio (CAR) demonstrated the highest predictive value (concordant index = 0.774) for objective response to EV.
An optimal CAR cutoff of 1 predicted significantly higher objective response rates (84% vs. 32%) in patients with lower CAR.
Eastern Cooperative Oncology Group Performance Status ≥1 and CAR ≥1 were identified as independent predictors of EV response.

Conclusions

The C-reactive protein-albumin ratio (CAR), assessed via a simple blood test, can effectively predict treatment response to enfortumab vedotin (EV).
CAR serves as a valuable biomarker for stratifying patients likely to benefit from EV in metastatic urothelial carcinoma.
This finding supports the integration of CAR assessment into routine clinical practice for guiding EV therapy decisions.