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Prognostic Value of C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index for Survival in Nivolumab-Treated Metastatic
Ali Fuat Gürbüz1, Mehmet Zahid Koçak1, Oğuzhan Yıldız1
1Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey.
Abstract:
Background and Objectives: Metastatic renal cell carcinoma (mRCC) remains a lethal disease despite advances with immune checkpoint inhibitors such as nivolumab. However, a substantial proportion of patients exhibit primary resistance or early progression, highlighting the need for reliable and easily accessible prognostic biomarkers. The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel immunonutritional biomarker integrating systemic inflammation, nutritional status, and immune competence. Materials and Methods: In this retrospective single-center study, 91 patients with mRCC treated with nivolumab were analyzed. Patients were stratified into low and high CALLY index groups based on a receiver operating characteristic-derived cut-off (0.322). Survival outcomes were assessed using Kaplan-Meier analysis and Cox regression models. Results: Patients with a low CALLY index demonstrated significantly shorter progression-free survival (4.5 vs. 13.5 months, p < 0.001) and overall survival (9.1 vs. 25.5 months, p = 0.003). Multivariate analysis confirmed the CALLY index as an independent prognostic factor for both progression-free survival (HR: 2.63, p = 0.002) and overall survival (HR: 1.88, p = 0.035). Conclusions: The CALLY index is a simple, cost-effective, and reproducible biomarker that independently predicts survival in nivolumab-treated mRCC. It may serve as a practical tool for risk stratification and personalized treatment planning in the immunotherapy era.
Insights
The C-reactive protein-albumin-lymphocyte (CALLY) index predicts survival in metastatic renal cell carcinoma (mRCC) patients treated with nivolumab. A low CALLY index indicates poorer outcomes, aiding in treatment planning.
Area of Science:
- Oncology
- Immunotherapy
- Biomarker Research
Background:
- Metastatic renal cell carcinoma (mRCC) is a significant cause of cancer mortality.
- Nivolumab offers advances but faces primary resistance and early progression challenges.
- Need for accessible prognostic biomarkers in mRCC immunotherapy.
Purpose of the Study:
- To evaluate the C-reactive protein-albumin-lymphocyte (CALLY) index as a prognostic biomarker in mRCC patients treated with nivolumab.
- To assess the correlation between the CALLY index and survival outcomes.
Main Methods:
- Retrospective analysis of 91 mRCC patients treated with nivolumab.
- Stratification into low and high CALLY index groups using ROC-derived cut-off (0.322).
- Survival analysis using Kaplan-Meier and Cox regression models.
Main Results:
- Low CALLY index associated with significantly shorter progression-free survival (4.5 vs. 13.5 months) and overall survival (9.1 vs. 25.5 months).
- Multivariate analysis identified CALLY index as an independent prognostic factor for PFS (HR: 2.63) and OS (HR: 1.88).
Conclusions:
- The CALLY index is a simple, cost-effective, and reproducible prognostic biomarker for nivolumab-treated mRCC.
- It aids in risk stratification and personalized treatment planning in the immunotherapy era.