{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:34:24Z","timestamp":1793144064346,"version":"4.5.0"},"reference-count":43,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been investigated as an immunonutritional biomarker in several solid tumors; however, data in metastatic renal cell carcinoma (mRCC) remain limited. This study aimed to evaluate the prognostic significance of the pretreatment HALP score in patients with mRCC receiving first-line tyrosine kinase inhibitor (TKI) therapy. Methods: A multicenter retrospective cohort study was conducted using data from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) Database. HALP was calculated as hemoglobin (g\/dL) \u00d7 albumin (g\/dL) \u00d7 lymphocyte count (\u00d7109\/L)\/platelet count (\u00d7109\/L). Patients were categorized into HALP-low and HALP-high groups according to the cohort median HALP value. Results: A total of 1001 patients were enrolled. The median time to treatment failure (TTF) was significantly shorter in the HALP-low group than in the HALP-high group (7.43 months [95% CI 6.4\u20138.5] vs. 14.26 months [95% CI 12.1\u201316.4], p &lt; 0.001). The median overall survival (OS) was also significantly shorter in the HALP-low group (30.19 months [95% CI 25.2\u201335.1] vs. 46.06 months [95% CI 38.2\u201353.9], p &lt; 0.001). In multivariable analysis, a high HALP score remained independently associated with longer TTF (HR 0.73, 95% CI 0.62\u20130.86; p &lt; 0.001) and OS (HR 0.69, 95% CI 0.57\u20130.85; p &lt; 0.001). Conclusions: The pretreatment HALP score was independently associated with TTF and OS in patients with mRCC treated with first-line TKI therapy. These findings support the prognostic relevance of HALP in this treatment setting and warrant further evaluation of its potential role alongside established clinical risk models.<\/jats:p>","DOI":"10.3390\/cancers18132127","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:50:37Z","timestamp":1782867037000},"page":"2127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pretreatment HALP Score and Survival Outcomes in Patients with Metastatic Renal Cell Carcinoma Receiving First-Line Tyrosine Kinase Inhibitors: A Turkish Oncology Group Kidney Cancer Consortium (TKCC) Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6116-3936","authenticated-orcid":false,"given":"Murat","family":"G\u00fcnalt\u0131l\u0131","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, 34098 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8659-7327","authenticated-orcid":false,"given":"Hatice","family":"B\u00f6lek","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Bilkent City Hospital, 06800 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esma","family":"Kaplan T\u00fcz\u00fcn","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, G\u00fclhane Training and Research Hospital, University of Health Science, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sura","family":"Usta","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Science, 06200 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9586-2858","authenticated-orcid":false,"given":"Safa Can","family":"Efil","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Bilkent City Hospital, 06800 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3922-3845","authenticated-orcid":false,"given":"Aysun Fatma","family":"Akkus","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Trakya University School of Medicine, 22030 Edirne, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selver","family":"I\u015f\u0131k","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Marmara University School of Medicine, 34899 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8879-8533","authenticated-orcid":false,"given":"Caner","family":"Kapar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sakarya Training and Research Hospital, 54100 Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4650-248X","authenticated-orcid":false,"given":"Serhat","family":"Sekmek","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Amasya Training and Research Hospital, 05100 Amasya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8310-1752","authenticated-orcid":false,"given":"Halil G\u00f6ksel","family":"G\u00fczel","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Antalya Training and Research Hospital, 06100 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2981-8098","authenticated-orcid":false,"given":"Murad","family":"Guliyev","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, 34098 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5927-8387","authenticated-orcid":false,"given":"Talha","family":"Ozudogru","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ege University School of Medicine, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1222-0444","authenticated-orcid":false,"given":"Sema Sezin","family":"G\u00f6ksu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Akdeniz University School of Medicine, 07070 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-9360","authenticated-orcid":false,"given":"\u00d6zlem Nuray","family":"Sever","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Istanbul Sancaktepe \u015eehit Prof. Dr. \u0130lhan Varank Training and Research Hospital, 34785 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c7agatay","family":"Arslan","sequence":"additional","affiliation":[{"name":"Medical Point Hospital, Izmir University of Economics, 35575 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuri","family":"Karadurmu\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, G\u00fclhane Training and Research Hospital, University of Health Science, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-6139","authenticated-orcid":false,"given":"Mehmet Ali Nahit","family":"Sendur","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Bilkent City Hospital, 06800 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz","family":"Tural","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Koc University, 34450 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8417-8628","authenticated-orcid":false,"given":"Mustafa","family":"\u00d6zg\u00fcro\u011flu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, 34098 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6819-5930","authenticated-orcid":false,"given":"Emre","family":"Yeked\u00fcz","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara University School of Medicine, 06230 Ankara, Turkey"},{"name":"Ankara University Cancer Institute, 06590 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9152-9887","authenticated-orcid":false,"given":"Y\u00fcksel","family":"\u00dcr\u00fcn","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara University School of Medicine, 06230 Ankara, Turkey"},{"name":"Ankara University Cancer Institute, 06590 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17009","DOI":"10.1038\/nrdp.2017.9","article-title":"Renal cell carcinoma","volume":"3","author":"Hsieh","year":"2017","journal-title":"Nat. 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