Pretreatment HALP Score and Survival Outcomes in Patients with Metastatic Renal Cell Carcinoma Receiving First-Line...

Background/Objectives: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been investigated as an immunonutritional biomarker in several solid tumors; however, data in metastatic renal cell carcinoma (mRCC) remain limited. This study aimed to evaluate the prognostic significance of the pretreatment HALP score in patients with mRCC receiving first-line tyrosine kinase inhibitor (TKI) therapy. Methods: A multicenter retrospective cohort study was conducted using data from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) Database. HALP was calculated as hemoglobin (g/dL) × albumin (g/dL) × lymphocyte count (×10⁹/L)/platelet count (×10⁹/L). Patients were categorized into HALP-low and HALP-high groups according to the cohort median HALP value. Results: A total of 1001 patients were enrolled. The median time to treatment failure (TTF) was significantly shorter in the HALP-low group than in the HALP-high group (7.43 months [95% CI 6.4-8.5] vs. 14.26 months [95% CI 12.1-16.4], p < 0.001). The median overall survival (OS) was also significantly shorter in the HALP-low group (30.19 months [95% CI 25.2-35.1] vs. 46.06 months [95% CI 38.2-53.9], p < 0.001). In multivariable analysis, a high HALP score remained independently associated with longer TTF (HR 0.73, 95% CI 0.62-0.86; p < 0.001) and OS (HR 0.69, 95% CI 0.57-0.85; p < 0.001). Conclusions: The pretreatment HALP score was independently associated with TTF and OS in patients with mRCC treated with first-line TKI therapy. These findings support the prognostic relevance of HALP in this treatment setting and warrant further evaluation of its potential role alongside established clinical risk models.