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ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2025

Uncovering prognostic biomarkers through a pharmacovigilance study: the case of RDW.

Valerio Liguori, Antonietta Anatriello, Alessia Zinzi, Angela Ragone, Ciro Pentella, Annalisa Capuano, Concetta Rafaniello, Silvio Naviglio, Luigi Sapio

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Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Valerio Liguori *Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.
Antonietta AnatrielloCampania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.
Alessia ZinziCampania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.
Angela RagoneDepartment of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Ciro PentellaCampania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy. ciro.pentella@unicampania.it.ORCID http://orcid.org/0009-0008-7103-3391
Annalisa CapuanoCampania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.
Concetta Rafaniello *Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.
Silvio Naviglio *Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Luigi Sapio *Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent studies highlighted the potential role of Red cell distribution width (RDW) as a prognostic biomarker in oncology. RDW has been associated with systemic inflammation, a key factor in cancer progression. While clinical trials and cohort studies suggest a correlation between RDW alterations and poor prognosis, its specific role in patients undergoing Immune Checkpoint Inhibitor (ICI) therapy remains unclear.

aimThis study aims to explore the potential relationship between RDW alterations and treatment outcomes in patients treated with PD-1 inhibitors using pharmacovigilance data from Eudra Vigilance (EV).

methodsWe retrieved Individual Case Safety Reports from EV database, reporting pembrolizumab or nivolumab as suspected drug (January 2015 to March 2025). The Reporting Odds Ratio (ROR) with its 95% of Confidence Interval (95% CI) was computed to assess if drugs of interest have a lower/higher probability of reporting adverse events (AEs) belonging to the System Organ Class "Investigation".

resultsOf 12,289 ICSRs, 6981 (56.8%) involved pembrolizumab and 5308 (43.2%) nivolumab. Most ICSRs referred to male patients aged 18-64. Pembrolizumab showed higher reporting probability of "Platelet count decreased" (ROR 2.41, 95% CI 2.14-2.72), "Neutrophil count decreased" (ROR 1.55, 95% CI 1.34-1.80), "White blood cell count decreased" (ROR 1.50, 95% CI 1.26-1.78), "Blood creatinine increased" (ROR 1.19, 95% CI 1.01-1.42), "C-reactive protein increased" (ROR 1.28, 95% CI 1.07-1.53) compared to nivolumab.

conclusionThis study provides new insights into the potential prognostic value of RDW in patients treated with ICIs. These results warrant further investigations to determine its utility in monitoring ICI therapy.

Indexed as

Erythrocyte IndicesImmune Checkpoint InhibitorsNeoplasmsPharmacovigilanceAdultAdverse Drug Reaction Reporting SystemsAgedAntibodies, Monoclonal, HumanizedBiomarkersFemaleHumansMaleMiddle AgedNivolumabPrognosisAntibodies, Monoclonal, HumanizedBiomarkersImmune Checkpoint InhibitorsNivolumabpembrolizumabHaematological parametersImmune checkpoint inhibitorsNivolumabPembrolizumabRed cell distribution widthSafety

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.