Jacqueline S L Kloth1, Paul Hamberg2, Pauline A J Mendelaar1, Roderick R Dulfer1, Bronno van der Holt3, Karel Eechoute1, Erik A C Wiemer1, Wim H J Kruit1, Stefan Sleijfer1, Ron H J Mathijssen4. 1. Dept of Medical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075 EA, Rotterdam, The Netherlands. 2. Dept of Internal Medicine, Sint Franciscus Gasthuis, Kleiweg 500, 3045 PM, Rotterdam, The Netherlands. 3. Clinical Trial Center, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075 EA, Rotterdam, The Netherlands. 4. Dept of Medical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075 EA, Rotterdam, The Netherlands. Electronic address: a.mathijssen@erasmusmc.nl.
Abstract
AIM OF THE STUDY: As a rise in mean corpuscular volume (MCV) of the erythrocyte is frequently seen during treatment with imatinib and sunitinib, we investigated whether macrocytosis (MCV > 100 fl) also occurs as a class effect in other tyrosine kinase inhibitors (TKIs) and whether occurrence of macrocytosis is associated with outcome. MATERIALS AND METHODS: In 533 patients, using 5 TKIs, we investigated if macrocytosis and an increase in MCV were associated with progression-free survival and overall survival (OS) in specific tumour-treatment combinations. RESULTS: Macrocytosis as well as an increase in MCV from baseline of >10 fl (ΔMCV +10 fl), when included as a time-dependent covariate, were associated with improved OS in patients with renal cell cancer (RCC) treated with sunitinib (macrocytosis, hazard ratio [HR] = 0.61, p = 0.031, and ΔMCV +10 fl, HR = 0.58, p = 0.016). CONCLUSION: In sunitinib-treated patients with RCC, the occurrence of macrocytosis, or a substantial increase in MCV levels after start of treatment, could potentially serve as a positive prognostic factor for survival, if validated prospectively.
AIM OF THE STUDY: As a rise in mean corpuscular volume (MCV) of the erythrocyte is frequently seen during treatment with imatinib and sunitinib, we investigated whether macrocytosis (MCV > 100 fl) also occurs as a class effect in other tyrosine kinase inhibitors (TKIs) and whether occurrence of macrocytosis is associated with outcome. MATERIALS AND METHODS: In 533 patients, using 5 TKIs, we investigated if macrocytosis and an increase in MCV were associated with progression-free survival and overall survival (OS) in specific tumour-treatment combinations. RESULTS: Macrocytosis as well as an increase in MCV from baseline of >10 fl (ΔMCV +10 fl), when included as a time-dependent covariate, were associated with improved OS in patients with renal cell cancer (RCC) treated with sunitinib (macrocytosis, hazard ratio [HR] = 0.61, p = 0.031, and ΔMCV +10 fl, HR = 0.58, p = 0.016). CONCLUSION: In sunitinib-treated patients with RCC, the occurrence of macrocytosis, or a substantial increase in MCV levels after start of treatment, could potentially serve as a positive prognostic factor for survival, if validated prospectively.
Authors: Keith C Bible; Michael E Menefee; Chia-Chi Josh Lin; Michael J Millward; William J Maples; Boon Cher Goh; Nina J Karlin; Madeleine A Kane; Douglas R Adkins; Julian R Molina; Ross C Donehower; Wan-Teck Lim; Patrick J Flynn; Ronald L Richardson; Anne M Traynor; Joseph Rubin; Patricia M LoRusso; Robert C Smallridge; Jill K Burton; Vera J Suman; Aditi Kumar; Jessie S Voss; Kandalaria M Rumilla; Benjamin R Kipp; Ashish V Chintakuntlawar; Pamela Harris; Charles Erlichman Journal: Thyroid Date: 2020-07-29 Impact factor: 6.568