C-reactive protein (CRP) as a prognostic biomarker in patients with urothelial carcinoma: A systematic review and meta-analysis

Yu Fujiwara, Alexander B. Karol, Himanshu Joshi, Emma Reford, Sudeh Izadmehr, Deborah B. Doroshow, Matthew D. Galsky

Research output: Contribution to journalReview articlepeer-review

Abstract

C-reactive protein (CRP) may reflect a pro-inflammatory tumor microenvironment and could represent a biomarker to select patients with urothelial carcinoma more likely to benefit from therapies directed at modulating tumor-promoting inflammation. We performed a systematic review to evaluate survival outcomes based on pre-treatment CRP values in urothelial carcinoma. The hazard ratios (HRs) of survival such as overall survival (OS) and progression-free survival (PFS) between groups with high versus low CRP values were pooled by the random-effect model meta-analyses. Overall, 28 studies comprising 6789 patients were identified for meta-analyses. High CRP levels were associated with shorter OS (HR=1.96 [95% CI: 1.64–2.33], p < 0.01), particularly in advanced disease treated with immune checkpoint blockade (ICB, HR=1.78 [1.47–2.15], p < 0.01). Similar findings were observed in ICB-treated patients with PFS. These findings suggest that CRP could be an attractive biomarker to select patients with urothelial carcinoma for strategies seeking to modulate tumor-promoting inflammation.

Original languageEnglish
Article number104352
JournalCritical Reviews in Oncology/Hematology
Volume197
DOIs
StatePublished - May 2024

Keywords

  • Biomarker
  • Bladder cancer
  • C-reactive protein
  • Immune checkpoint blockade
  • Urothelial carcinoma

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