Aim: We aimed to assess the prognostic value of pretreatment hematological biomarkers in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors (ICIs). Methods: PubMed, Web of Science and Scopus databases were searched for articles according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: Fifteen studies comprising 1530 patients were eligible for meta-analysis. High levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein and lactate dehydrogenase were significantly associated with worse progression-free survival. High NLR and PLR were significantly associated with worse overall survival. Conclusion: High pretreatment NLR and PLR appear to be hematological prognostic factors of progression and overall mortality in mRCC patients treated with ICIs. These findings might help in the design of correlative biomarker studies to guide the clinical decision-making in the immune checkpoint inhibitor era.

Identifying the predictive/prognostic factors that can be applied to daily clinical practice is mandatory to facilitate the use of immune checkpoint inhibitors. Some pretreatment hematological markers used in daily clinical practice appear to be prognostic factors in metastatic renal cell carcinoma patients treated with immune checkpoint inhibitors. We believe that the findings of the present meta-analysis might help researchers to design prospective correlative biomarker studies to guide clinical decision-making in the immunotherapy era.

Department of Medicine 1 and Comprehensive Cancer Center Clinical Division of Oncology Medical University of Vienna Vienna 1090 Austria

Department of Urology 2nd Faculty of Medicine Charles University Prague 11638 Czech Republic

Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna 1090 Austria

Department of Urology King Fahad Specialist Hospital Dammam 32253 Saudi Arabia

Department of Urology King Faisal Medical City Abha 614312 Saudi Arabia

Department of Urology Luzerner Kantonsspital Lucerne 6004 Switzerland

Department of Urology Medical University of Silesia Zabrze 41 808 Poland

Department of Urology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama 700 8558 Japan

Department of Urology The Jikei University School of Medicine Tokyo105 8461 Japan

Department of Urology University Hospital Zurich Zurich 8091 Switzerland

Department of Urology University Medical Centre Hamburg Eppendorf Hamburg 20251 Germany

Department of Urology University of Texas Southwestern Medical Center Dallas TX 75390 USA

Department of Urology Weill Cornell Medical College New York NY 10021 USA

Division of Urology Hourani Center for Applied Scientific Research Al Ahliyya Amman University Amman 19328 Jordan

Institute for Urology and Reproductive Health Sechenov University Moscow 119991 Russia

Karl Landsteiner Institute of Urology and Andrology Vienna 1010 Austria

Men's Health and Reproductive Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran

Research Center for Evidence Based Medicine Tabriz University of Medical Sciences Tabriz 5166 Iran

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