Association between serum uric acid levels and clinical outcomes of immunotherapy in advanced colorectal cancer patients.
[BACKGROUND] Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) colorectal cancer, offering durable cl
- p-value p = 0.001
- p-value p = 0.015
- 95% CI 1.04-6.12
- HR 2.73
- Sensitivity 70.0%
- Specificity 70.8%
- 추적기간 21.1 months
APA
Fan S, Shao M, Ma W (2026). Association between serum uric acid levels and clinical outcomes of immunotherapy in advanced colorectal cancer patients.. BMC cancer, 26(1), 171. https://doi.org/10.1186/s12885-025-15431-y
MLA
Fan S, et al.. "Association between serum uric acid levels and clinical outcomes of immunotherapy in advanced colorectal cancer patients.." BMC cancer, vol. 26, no. 1, 2026, pp. 171.
PMID
41484953
Abstract
[BACKGROUND] Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) colorectal cancer, offering durable clinical benefits to a subset of patients. However, long-term survival is heterogeneous, and effective risk-stratification biomarkers for this subgroup are needed. This study investigated the prognostic significance of baseline serum uric acid (UA) levels in patients with dMMR/MSI-H colorectal cancer undergoing ICI therapy.
[PATIENTS AND METHODS] This retrospective study enrolled 171 patients with advanced dMMR/MSI-H colorectal cancer receiving ICIs (monotherapy or combined with chemotherapy/targeted agents). Serum UA was measured within three days pre-treatment. An optimal UA cut-off was determined by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier estimates and Cox proportional hazards models assessed the UA-overall survival (OS) association.
[RESULTS] Median follow-up was 21.1 months (range: 1.2-48.0). ROC analysis identified an optimal serum UA threshold of 274 µmol/L (Area Under Curve (AUC) = 0.82; sensitivity = 70.0%; specificity = 70.8%). Patients with UA ≥ 274 µmol/L exhibited significantly shorter OS compared to those with lower UA (Hazard Ratio (HR) = 2.31; 95% CI: 1.04-6.12; p = 0.001). Multivariate analysis confirmed elevated UA as an independent predictor of poorer OS (HR = 2.73; 95% CI: 1.37-6.16; p = 0.015), alongside stage IV disease, concurrent use of multiple ICI agents and the use of immunotherapy in the ≥ 3rd-line setting.
[CONCLUSION] Elevated baseline serum UA is associated with poorer long-term survival in patients with dMMR/MSI-H advanced colorectal cancer receiving immunotherapy. As an accessible and cost-effective biomarker, UA shows potential for early risk-stratification and guiding individualized treatment strategies within this immunotherapy-sensitive population.
[PATIENTS AND METHODS] This retrospective study enrolled 171 patients with advanced dMMR/MSI-H colorectal cancer receiving ICIs (monotherapy or combined with chemotherapy/targeted agents). Serum UA was measured within three days pre-treatment. An optimal UA cut-off was determined by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier estimates and Cox proportional hazards models assessed the UA-overall survival (OS) association.
[RESULTS] Median follow-up was 21.1 months (range: 1.2-48.0). ROC analysis identified an optimal serum UA threshold of 274 µmol/L (Area Under Curve (AUC) = 0.82; sensitivity = 70.0%; specificity = 70.8%). Patients with UA ≥ 274 µmol/L exhibited significantly shorter OS compared to those with lower UA (Hazard Ratio (HR) = 2.31; 95% CI: 1.04-6.12; p = 0.001). Multivariate analysis confirmed elevated UA as an independent predictor of poorer OS (HR = 2.73; 95% CI: 1.37-6.16; p = 0.015), alongside stage IV disease, concurrent use of multiple ICI agents and the use of immunotherapy in the ≥ 3rd-line setting.
[CONCLUSION] Elevated baseline serum UA is associated with poorer long-term survival in patients with dMMR/MSI-H advanced colorectal cancer receiving immunotherapy. As an accessible and cost-effective biomarker, UA shows potential for early risk-stratification and guiding individualized treatment strategies within this immunotherapy-sensitive population.
MeSH Terms
Humans; Colorectal Neoplasms; Male; Uric Acid; Female; Middle Aged; Aged; Retrospective Studies; Prognosis; Immune Checkpoint Inhibitors; Adult; Immunotherapy; Aged, 80 and over; Biomarkers, Tumor; Microsatellite Instability; Treatment Outcome; Kaplan-Meier Estimate; ROC Curve; DNA Mismatch Repair
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