{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:18:21Z","timestamp":1793121501311,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Metastatic renal cell carcinoma (mRCC) remains a lethal disease despite advances with immune checkpoint inhibitors such as nivolumab. However, a substantial proportion of patients exhibit primary resistance or early progression, highlighting the need for reliable and easily accessible prognostic biomarkers. The C-reactive protein\u2013albumin\u2013lymphocyte (CALLY) index is a novel immunonutritional biomarker integrating systemic inflammation, nutritional status, and immune competence. Materials and Methods: In this retrospective single-center study, 91 patients with mRCC treated with nivolumab were analyzed. Patients were stratified into low and high CALLY index groups based on a receiver operating characteristic-derived cut-off (0.322). Survival outcomes were assessed using Kaplan\u2013Meier analysis and Cox regression models. Results: Patients with a low CALLY index demonstrated significantly shorter progression-free survival (4.5 vs. 13.5 months, p &lt; 0.001) and overall survival (9.1 vs. 25.5 months, p = 0.003). Multivariate analysis confirmed the CALLY index as an independent prognostic factor for both progression-free survival (HR: 2.63, p = 0.002) and overall survival (HR: 1.88, p = 0.035). Conclusions: The CALLY index is a simple, cost-effective, and reproducible biomarker that independently predicts survival in nivolumab-treated mRCC. It may serve as a practical tool for risk stratification and personalized treatment planning in the immunotherapy era.<\/jats:p>","DOI":"10.3390\/medicina62061009","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:14:52Z","timestamp":1779452092000},"page":"1009","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic Value of C-Reactive Protein\u2013Albumin\u2013Lymphocyte (CALLY) Index for Survival in Nivolumab-Treated Metastatic Renal Cell Carcinoma"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1455-471X","authenticated-orcid":false,"given":"Ali Fuat","family":"G\u00fcrb\u00fcz","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3085-7964","authenticated-orcid":false,"given":"Mehmet Zahid","family":"Ko\u00e7ak","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4057-3108","authenticated-orcid":false,"given":"O\u011fuzhan","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4252-1029","authenticated-orcid":false,"given":"\u00d6mer","family":"Gen\u00e7","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3414-5596","authenticated-orcid":false,"given":"Bahattin Engin","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9614-0651","authenticated-orcid":false,"given":"Talat","family":"Aykut","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melek Karakurt","family":"Ery\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4632-9501","authenticated-orcid":false,"given":"Murat","family":"Araz","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2335-3354","authenticated-orcid":false,"given":"Mehmet","family":"Arta\u00e7","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Necmettin Erbakan University, Konya 42080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1056\/NEJMoa1510665","article-title":"Nivolumab versus Everolimus in Advanced Renal-Cell Carcinoma","volume":"373","author":"Motzer","year":"2015","journal-title":"N. 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