Prognostic impact of the pretreatment aspartate transaminase/alanine transaminase ratio in patients treated with first‐line systemic tyrosine kinase inhibitor therapy for metastatic renal cell carcinoma

Abstract

Our findings show that the pretreatment De Ritis ratio can provide valuable information about the survival outcomes of metastatic renal cell carcinoma patients receiving first-line tyrosine kinase inhibitor therapy.

Pre-treatment De Ritis ratio serves as a potential prognostic biomarker in renal cell carcinoma: a systematic review and meta-analysis

“…Initially identi ed 267 articles through the search strategy, 19 studies remained after removing duplicates and excluding articles by viewing titles and abstracts. Based on corresponding inclusion and exclusion criteria, 8 articles comprising 5,025 patients were nally included in the present study [14,15,[18][19][20][21][22][23] ( Figure 1). All studies had a retrospective design, two of which were propensity score-matched analyses.…”

“…3 studies focused on metastatic RCC [19,21,22], 5 studies focused on non-metastatic RCC [14,15,18,20,23]. These studies were conducted in ve countries, including China, Korea, Turkey, Japan, and the United States.…”

Editorial Comment from Dr Yuasa to Prognostic impact of the pretreatment aspartate transaminase/alanine transaminase ratio in patients treated with first‐line systemic tyrosine kinase inhibitor therapy for metastatic renal cell carcinoma

“…In this issue of the International Journal of Urology , Kang et al . showed the usefulness of the De Ritis ratio as a predictive marker in metastatic RCC patients who received first‐line systemic targeted therapy . Patients with a higher pretreatment De Ritis ratio (≥1.2) had worse CSS and OS outcomes, compared with those with a lower De Ritis ratio (<1.2).…”

“…A potential weak point of these criteria is that a relatively high number of patients are classified into the intermediate‐risk group. The application of the De Ritis ratio, using stratification by above or below 1.2 (AST/ALT), resulted in populations with distinctly separate CSS and OS outcomes in the intermediate‐risk group, although no significant effect was found on survival outcome among the patients in the favorable and poor risk groups . The AST and ALT levels can be easily evaluated and monitored routinely without invasive procedures.…”

Editorial Comment from Dr Teishima and Dr Matsubara to Prognostic impact of the pretreatment aspartate transaminase/alanine transaminase ratio in patients treated with first‐line systemic tyrosine kinase inhibitor therapy for metastatic renal cell carcinoma

“…Kang et al . reported the prognostic impact of the aspartate transaminase (AST)/alanine transaminase (ALT) ratio, referred to as the De Ritis ratio, in metastatic renal cell carcinoma (mRCC) patients treated with first‐line systemic tyrosine kinase inhibitor . Their study showed that patients with a higher De Ritis ratio had worse cancer‐specific survival and overall survival than those with a lower ratio.…”