Hideaki Miyake1, Akira Miyazaki2, Satoshi Imai2, Ken-Ichi Harada2, Masato Fujisawa2. 1. Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. hideakimiyake@hotmail.com. 2. Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Abstract
BACKGROUND: Prognostic significance of early tumor shrinkage following treatment with tyrosine kinase inhibitors (TKIs) in patients with metastatic renal cell carcinoma (mRCC) has not been fully elucidated. OBJECTIVE: The aim of this study was to assess the impact of early tumor shrinkage induced by first-line TKIs on overall survival (OS) in mRCC patients. PATIENTS AND METHODS: This study retrospectively included 185 consecutive Japanese patients with mRCC treated with either sunitinib or sorafenib for at least 3 months as first-line molecular-targeted therapy between April 2011 and December 2014 at Kobe University Hospital and its affiliated institutions. RESULTS: Median OS in the 185 patients was 33.6 months. At 12 weeks after the introduction of TKIs, 9 patients had achieved tumor shrinkage from -100 to -50 %, 43 from -49 to -25 %, 61 from -24 to 0 %, and the remaining 72 patients showed an increase in tumor size. The median OS stratified according to tumor shrinkage as shown above was 59.2, 39.1, 31.4, and 16.1 months, respectively. Univariate analysis identified prior nephrectomy, Memorial Sloan Kettering Cancer Center (MSKCC) risk classification, C-reactive protein (CRP) level, liver metastasis, number of metastatic organs, histological subtype, sarcomatoid feature, and early tumor shrinkage as significant predictors of OS. Of these significant factors, only the MSKCC classification, CRP level, liver metastasis, and early tumor shrinkage were shown to be independently associated with OS on multivariate analysis. CONCLUSIONS: Early tumor shrinkage could be a useful predictor of OS in mRCC patients receiving TKIs as a first-line molecular-targeted agent.
BACKGROUND: Prognostic significance of early tumor shrinkage following treatment with tyrosine kinase inhibitors (TKIs) in patients with metastatic renal cell carcinoma (mRCC) has not been fully elucidated. OBJECTIVE: The aim of this study was to assess the impact of early tumor shrinkage induced by first-line TKIs on overall survival (OS) in mRCC patients. PATIENTS AND METHODS: This study retrospectively included 185 consecutive Japanese patients with mRCC treated with either sunitinib or sorafenib for at least 3 months as first-line molecular-targeted therapy between April 2011 and December 2014 at Kobe University Hospital and its affiliated institutions. RESULTS: Median OS in the 185 patients was 33.6 months. At 12 weeks after the introduction of TKIs, 9 patients had achieved tumor shrinkage from -100 to -50 %, 43 from -49 to -25 %, 61 from -24 to 0 %, and the remaining 72 patients showed an increase in tumor size. The median OS stratified according to tumor shrinkage as shown above was 59.2, 39.1, 31.4, and 16.1 months, respectively. Univariate analysis identified prior nephrectomy, Memorial Sloan Kettering Cancer Center (MSKCC) risk classification, C-reactive protein (CRP) level, liver metastasis, number of metastatic organs, histological subtype, sarcomatoid feature, and early tumor shrinkage as significant predictors of OS. Of these significant factors, only the MSKCC classification, CRP level, liver metastasis, and early tumor shrinkage were shown to be independently associated with OS on multivariate analysis. CONCLUSIONS: Early tumor shrinkage could be a useful predictor of OS in mRCC patients receiving TKIs as a first-line molecular-targeted agent.
Authors: Katherine M Krajewski; Yoko Franchetti; Mizuki Nishino; André P Fay; Nikhil Ramaiya; Annick D Van den Abbeele; Toni K Choueiri Journal: Oncologist Date: 2014-04-22
Authors: Lauren C Harshman; Wanling Xie; Georg A Bjarnason; Jennifer J Knox; Mary MacKenzie; Lori Wood; Sandy Srinivas; Ulka N Vaishampayan; Min-Han Tan; Sun-Young Rha; Frede Donskov; Neeraj Agarwal; Christian Kollmannsberger; Scott North; Brian I Rini; Daniel Y C Heng; Toni K Choueiri Journal: Lancet Oncol Date: 2012-08-08 Impact factor: 41.316
Authors: Bernard Escudier; Tim Eisen; Walter M Stadler; Cezary Szczylik; Stéphane Oudard; Michael Siebels; Sylvie Negrier; Christine Chevreau; Ewa Solska; Apurva A Desai; Frédéric Rolland; Tomasz Demkow; Thomas E Hutson; Martin Gore; Scott Freeman; Brian Schwartz; Minghua Shan; Ronit Simantov; Ronald M Bukowski Journal: N Engl J Med Date: 2007-01-11 Impact factor: 91.245
Authors: Robert J Motzer; Thomas E Hutson; Piotr Tomczak; M Dror Michaelson; Ronald M Bukowski; Olivier Rixe; Stéphane Oudard; Sylvie Negrier; Cezary Szczylik; Sindy T Kim; Isan Chen; Paul W Bycott; Charles M Baum; Robert A Figlin Journal: N Engl J Med Date: 2007-01-11 Impact factor: 91.245
Authors: Daniel Y C Heng; Wanling Xie; Meredith M Regan; Mark A Warren; Ali Reza Golshayan; Chakshu Sahi; Bernhard J Eigl; J Dean Ruether; Tina Cheng; Scott North; Peter Venner; Jennifer J Knox; Kim N Chi; Christian Kollmannsberger; David F McDermott; William K Oh; Michael B Atkins; Ronald M Bukowski; Brian I Rini; Toni K Choueiri Journal: J Clin Oncol Date: 2009-10-13 Impact factor: 44.544
Authors: Jacob Farnebo; Per Grybäck; Ulrika Harmenberg; Anna Laurell; Peter Wersäll; Lennart K Blomqvist; Anders Ullén; Per Sandström Journal: BMC Cancer Date: 2014-06-06 Impact factor: 4.430
Authors: Lukas Müller; Simon Johannes Gairing; Roman Kloeckner; Friedrich Foerster; Eva Maria Schleicher; Arndt Weinmann; Jens Mittler; Fabian Stoehr; Moritz Christian Halfmann; Christoph Düber; Peter Robert Galle; Felix Hahn Journal: Cancer Imaging Date: 2022-09-24 Impact factor: 5.605