Abstract:
Objective To investigate the effect of hyponatremia on the survival of cancer patients treated with camrelizumab.
Methods The clinical and follow-up data of 100 patients treated with camrelizumab for the first time in Zhongshan Hospital, Fudan University from May 2019 to May 2020 were collected retrospectively, and the patients were divided into hyponatremia group and normal blood sodium group according to the blood sodium level at baseline before immunotherapy. Chi-square test was used to compare categorical variables between the two groups. Kaplan-Meier method with log-rank test was used to analyze survival of patients. Cox regression analysis was conducted to evaluate the impact of hyponatremia on prognosis.
Results There were no statistically significant differences in gender, age, body mass index, Eastern Cooperative Oncology Group performance status (ECOG PS) score, nutritional risk screening 2002 (NRS2002) score, tumor site, TNM stage, metastasis site number, and concurrent medication between the two groups. The median overall survival in the hyponatremia group and the normal sodium group was 3.9 months (95% CI 2.864-5.136) and 14.967 months (95% CI 6.840-23.093), respectively (P < 0.05); the median progression-free survival in the hyponatremia group and the normal sodium group was 2.933 months (95% CI 2.420-3.447) and 7.0 months (95% CI 4.103-9.897), respectively (P < 0.05). After adjusting for primary tumor, statistically differences were also observed in both overall survival and progression-free survival between the two groups (P < 0.05). The multivariate Cox analysis showed that both the death and disease progression risks of patients with hyponatremia increased (P < 0.05). After adjusting for age, gender, primary tumor site, and TNM staging, the blood sodium level remained independent influences on both overall survival and progression-free survival of patients (P < 0.05).
Conclusion Baseline hyponatremia may be associated with the prognosis of patients with malignant tumors treated with camrelizumab, and further validation is warranted through large-scale prospective studies.