title: The longitudinal relationship between the systemic inflammatory response, circulating T-lymphocytes, interleukin-6 and -10 in patients undergoing immunotherapy for metastatic renal cancer.
abstract: OBJECTIVE
  To examine the longitudinal relationship between the systemic inflammatory response, circulating T-lymphocyte subpopulations, interleukin-6 and -10 in patients undergoing immunotherapy for metastatic renal cancer, as the inflammation-based Glasgow Prognostic Score (GPS) provides additional prognostic information in patients with advanced renal cancer, but the basis of the relationship between the systemic inflammatory response and poorer survival is not clear, and nor is the effect of immunotherapy on related variables.
  
  
  METHODS
  The study included 23 patients with metastatic renal cancer and starting immunotherapy. Samples of blood were drawn for routine laboratory analysis and to quantify cytokines using enzyme-linked immunosorbent assays before immunotherapy, and repeated after 2 weeks of treatment.
  
  
  RESULTS
  Most patients had a good performance status, favourable or intermediate Memorial Sloane-Kettering Cancer Center (MSKCC) risk scores, and with elevated C-reactive protein (>10 mg/L), GPS (1 or 2), interleukin-6 (>4 pg/mL) and interleukin-10 (>10 pg/mL). Patients who completed one cycle of immunotherapy were more likely to have a normal MSKCC (P < 0.05) or GPS (P < 0.05) scores, whilst the percentage of lymphocytes was lower (P < 0.05). The MSKCC and the GPS scores did not alter significantly during one cycle of immunotherapy. Similarly, leukocyte counts, CD4+ and CD8+ T-lymphocytes, interleukin-6 and -10 concentrations did not change significantly.
  
  
  CONCLUSIONS
  The pretreatment systemic inflammatory response and its related lymphopenia are important in determining the tolerance to immunotherapy in patients with metastatic renal cancer. Immunotherapy is not associated with changes in circulating T-lymphocytes, nor the systemic inflammatory response.
authors.affiliation: Department of Urology, Gartnavel General Hospital, Glasgow, Scotland, UK. sara_l_ramsey@ntlworld.com
authors.forename: Sara
authors.initials: S
authors.lastname: Ramsey
authors.forename: Michael
authors.initials: M
authors.lastname: Aitchison
authors.forename: John
authors.initials: J
authors.lastname: Graham
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
mesh_terms: D000418:Albumins / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000276:immunology* / Q000628:therapy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007167:Immunotherapy; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D007680:Kidney Neoplasms / Q000276:immunology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology*; D013601:T-Lymphocytes / Q000378:metabolism*
chemical_list: D000418:Albumins; D015850:Interleukin-6; D016753:Interleukin-10; D002097:C-Reactive Protein