DOI QR코드

DOI QR Code

Factors Prognostic for Survival in Japanese Patients Treated with Sunitinib as First-line Therapy for Metastatic Clear Cell Renal Cell Cancer

  • Kawai, Y (Department of Urology, Graduate School of Medicine, Yamaguchi University) ;
  • Osawa, T (Department of Urology, Hokkaido Cancer Center) ;
  • Kobayashi, K (Department of Urology, Graduate School of Medicine, Yamaguchi University) ;
  • Inoue, R (Department of Urology, Graduate School of Medicine, Yamaguchi University) ;
  • Yamamoto, Y (Department of Urology, Graduate School of Medicine, Yamaguchi University) ;
  • Matsumoto, H (Department of Urology, Graduate School of Medicine, Yamaguchi University) ;
  • Nagao, K (Department of Urology, Graduate School of Medicine, Yamaguchi University) ;
  • Hara, T (Department of Urology, Graduate School of Medicine, Yamaguchi University) ;
  • Sakano, S (Department of Urology, Graduate School of Medicine, Yamaguchi University) ;
  • Nagamori, S (Department of Urology, Hokkaido Cancer Center) ;
  • Matsuyama, H (Department of Urology, Graduate School of Medicine, Yamaguchi University)
  • Published : 2015.09.02

Abstract

Background: Factors predictive of survival have been identified in Western patients with metastatic clear cell renal cell carcinoma (mCCRCC) treated with sunitinib. Less is known, however, about factors predictive of survival in Japanese patients. This study evaluated factors prognostic of survival in Japanese patients with mCCRCC treated with first-line sunitinib. Materials and Methods: This retrospective study evaluated 46 consecutive Japanese mCCRCC patients treated with sunitinib as first line therapy. Clinical and biochemical markers associated with progression-free survival (PFS) were analyzed, with prognostic factors selected by uniand multivariate Cox regression analyses. Results: Univariate analysis showed that factors significantly associated with poor PFS included Memorial Sloan-Kettering Cancer Center poor risk scores, International Metastatic RCC Database Consortium poor risk and high (>0.5 mg/dl) serum C-reactive protein (CRP) concentrations (p<0.001 each). Multivariate analysis showed that high serum CRP was independently associated with poorer PFS (p=0.040). Six month disease control rate (complete response, partial response and stable disease) in response to sunitinib was significantly higher in patients with normal (${\leq}0.5mg/dl$) than elevated baseline CRP (p<0.001). Conclusions: CRP is a significant independent predictor of PFS for Japanese patients with mCCRCC treated with first-line sunitinib. Pretreatment CRP concentration may be a useful biomarker predicting response to sunitinib treatment.

References

  1. Beuselinck B, Vano YA, Oudard S, et al (2014). Prognostic impact of baseline serum C-reactive protein in patients with metastatic renal cell carcinoma (RCC) treated with sunitinib. BJU Int, 114, 81-9. https://doi.org/10.1111/bju.12494
  2. Bromwich E, McMillan DC, Lamb GW, Vasey PA, Atchison M (2004). The systemic inflammatory response, performance status and survival in patients undergoing alpha-interferon treatment for advanced renal cancer. Br J Cancer, 91, 1236-8. https://doi.org/10.1038/sj.bjc.6602152
  3. Dai J, Tang K, Xiao W, et al (2014). Prognostic significance of C-reactive protein in urological cancers: a systematic review and meta-analysis. Asian Pac J Cancer Prev, 15, 3369-75. https://doi.org/10.7314/APJCP.2014.15.8.3369
  4. Dirican A, Kucukzeybek Y, Erten C, et al (2013). Prognostic and predictive value of hematologic parameters in patients with metastatic renal cell carcinoma: second line sunitinib treatment following IFN-alpha. Asian Pac J Cancer Prev, 14, 2101-5. https://doi.org/10.7314/APJCP.2013.14.3.2101
  5. Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ (2004). Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable nonsmall- cell lung cancer. Br J Cancer, 90, 1704-6.
  6. Fujita T, Iwamura M, Ishii D, et al (2012). C-reactive protein as a prognostic marker for advanced renal cell carcinoma treated with sunitinib. Int J Urol, 19, 908-13. https://doi.org/10.1111/j.1442-2042.2012.03071.x
  7. Gore ME, Szczylik C, Porta C, et al (2009). Safety and efficacy of sunitinib for metastatic renal-cell carcinoma: an expandedaccess trial. Lancet Oncol, 10, 757-63. https://doi.org/10.1016/S1470-2045(09)70162-7
  8. Gunduz S, Mutlu H, Uysal M, Coskun HS, Bozcuk H (2014). Prognostic value of hematologic parameters in patients with metastatic renal cell carcinoma using tyrosine kinase inhibitors. Asian Pac J Cancer Prev, 15, 3801-4. https://doi.org/10.7314/APJCP.2014.15.8.3801
  9. Heng DY, Xie W, Regan MM, et al (2009). Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factortargeted agents: results from a large, multicenter study. J Clin Oncol, 27, 5794-9. https://doi.org/10.1200/JCO.2008.21.4809
  10. Jee SH, Shen SC, Chiu HC, Tsai WL, Kuo ML (2001). Overexpression of interleukin-6 in human basal cell carcinoma cell lines increases anti-apoptotic activity and tumorigenic potency. Oncogene, 20, 198-208. https://doi.org/10.1038/sj.onc.1204076
  11. Karakiewicz PI, Hutterer GC, Trinh QD, et al (2007). C-reactive protein is an informative predictor of renal cell carcinomaspecific mortality: a European study of 313 patients. Cancer, 110, 1241-7. https://doi.org/10.1002/cncr.22896
  12. Kawashima A, Tsujimura A, Takayama H, et al (2012). Impact of hyponatremia on survival of patients with metastatic renal cell carcinoma treated with molecular targeted therapy. Int J Urol, 19, 1050-7; author reply 1058-9. https://doi.org/10.1111/j.1442-2042.2012.03115.x
  13. Kinoshita T, Ito H, Miki C (1999). Serum interleukin-6 level reflects the tumor proliferative activity in patients with colorectal carcinoma. Cancer, 85, 2526-31. https://doi.org/10.1002/(SICI)1097-0142(19990615)85:12<2526::AID-CNCR6>3.0.CO;2-3
  14. McKeown DJ, Brown DJ, Kelly A, Wallace AM, McMillan DC (2004). The relationship between circulating concentrations of C-reactive protein, inflammatory cytokines and cytokine receptors in patients with non-small-cell lung cancer. Br J Cancer, 91, 1993-5. https://doi.org/10.1038/sj.bjc.6602248
  15. McMillan DC, Scott HR, Watson WS, et al (1998). Longitudinal study of body cell mass depletion and the inflammatory response in cancer patients. Nutr Cancer, 31, 101-5. https://doi.org/10.1080/01635589809514687
  16. Miyake H, Miyazaki A, Harada K, Fujisawa (2014). Assessment of efficacy, safety and quality of life of 110 patients treated with sunitinib as first-line therapy for metastatic renal cell carcinoma: experience in real-world clinical practice in Japan. Med Oncol, 31, 978. https://doi.org/10.1007/s12032-014-0978-4
  17. Motzer RJ, Bacik J, Mazumdar M (2004). Prognostic factors for survival of patients with stage IV renal cell carcinoma: Memorial Sloan-Kettering Cancer Center experience. Clin Cancer Res, 10, 6302-3. https://doi.org/10.1158/1078-0432.CCR-040031
  18. Motzer RJ, Hutson TE, Tomczak P, et al (2009). Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol, 27, 3584-90. https://doi.org/10.1200/JCO.2008.20.1293
  19. Motzer RJ, Hutson TE, Tomczak P, et al (2007). Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med, 356, 115-24. https://doi.org/10.1056/NEJMoa065044
  20. Motzer RJ, Michaelson MD, Redman BG, et al (2006a). Activity of SU11248, a multitargeted inhibitor of vascular endothelial growth factor receptor and platelet-derived growth factor receptor, in patients with metastatic renal cell carcinoma. J Clin Oncol, 24, 16-24. https://doi.org/10.1200/JCO.2005.02.2574
  21. Motzer RJ, Rini BI, Bukowski RM, et al (2006b). Sunitinib in patients with metastatic renal cell carcinoma. JAMA, 295, 2516-24. https://doi.org/10.1001/jama.295.21.2516
  22. Naito S, Yamamoto N, Takayama T, et al (2010). Prognosis of Japanese metastatic renal cell carcinoma patients in the cytokine era: a cooperative group report of 1463 patients. Eur Urol, 57, 317-25. https://doi.org/10.1016/j.eururo.2008.12.026
  23. Rini BI, Atkins MB (2009). Resistance to targeted therapy in renal-cell carcinoma. Lancet Oncol, 10, 992-1000. https://doi.org/10.1016/S1470-2045(09)70240-2
  24. Rini BI, Cohen DP, Lu DR, et al (2011). Hypertension as a biomarker of efficacy in patients with metastatic renal cell carcinoma treated with sunitinib. J Natl Cancer Inst, 103, 763-73. https://doi.org/10.1093/jnci/djr128
  25. Schmidinger M, Vogl UM, Bojic M, et al (2011). Hypothyroidism in patients with renal cell carcinoma: blessing or curse? Cancer, 117, 534-44. https://doi.org/10.1002/cncr.25422
  26. Scott HR, McMillan DC, Forrest LM, et al (2002). The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer. Br J Cancer, 87, 264-7. https://doi.org/10.1038/sj.bjc.6600466
  27. Tomita Y, Shinohara N, Yuasa T, et al (2010). Overall survival and updated results from a phase II study of sunitinib in Japanese patients with metastatic renal cell carcinoma. Jpn J Clin Oncol, 40, 1166-72. https://doi.org/10.1093/jjco/hyq146
  28. Trikha M, Corringham R, Klein B, Rossi JF (2003). Targeted anti-interleukin-6 monoclonal antibody therapy for cancer: a review of the rationale and clinical evidence. Clin Cancer Res, 9, 4653-65.
  29. Uemura H, Shinohara N, Yuasa T, et al (2010). A phase II study of sunitinib in Japanese patients with metastatic renal cell carcinoma: insights into the treatment, efficacy and safety. Jpn J Clin Oncol, 40, 194-202. https://doi.org/10.1093/jjco/hyp146

Cited by

  1. Predictive value of C-reactive protein in patients treated with sunitinib for metastatic clear cell renal cell carcinoma vol.17, pp.1, 2017, https://doi.org/10.1186/s12894-017-0267-6
  2. Association of post-treatment hypoalbuminemia and survival in Chinese patients with metastatic renal cell carcinoma vol.36, pp.1, 2017, https://doi.org/10.1186/s40880-017-0214-7
  3. Sunitinib tolerance and efficacy in patients with metastatic renal cell carcinoma according to ethnic and geographic factors vol.49, pp.3, 2017, https://doi.org/10.1007/s11255-017-1502-5
  4. Treatment patterns and outcomes in patients with unresectable or metastatic renal cell carcinoma in Japan pp.09198172, 2018, https://doi.org/10.1111/iju.13830
  5. Role of systemic inflammatory response markers in urological malignancy pp.09198172, 2018, https://doi.org/10.1111/iju.13801