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Clinical and laboratory prognostic factors in patients with metastatic renal cell carcinoma treated with sunitinib and sorafenib after progression on cytokines
Authors:Alexandr Poprach  Tomas Pavlik  Bohuslav Melichar  Katerina Kubackova  Zbynek Bortlicek  Marek Svoboda  Radek Lakomy  Rostislav Vyzula  Igor Kiss  Ladislav Dusek  Tomas Buchler
Institution:1. Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic;2. Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic;3. Department of Oncology, Palacky University Medical School and Teaching Hospital, Olomouc, Czech Republic;4. Department of Oncology, University Hospital of Motol, Charles University, Prague, Czech Republic;5. Department of Oncology and 1st Faculty of Medicine, Thomayer Hospital and Charles University, Prague, Czech Republic
Abstract:ObjectivesThe aim of this retrospective study was to analyze prognostic factors in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors (TKIs) sunitinib or sorafenib after progression on cytokine therapy.Materials and methodsA national database of patients treated with targeted agents was used as the data source. A total of 319 patients treated with sunitinib (n = 181) or sorafenib (n = 138) after progression on cytokine therapy were analyzed.ResultsPrognostic factors significantly associated with poor overall survival in a multivariable Cox model included the time from diagnosis to the start of treatment with TKIs<1 year, increased neutrophil counts, increased lactate dehydrogenase, and Eastern Oncology Cooperative Group performance status 2 or higher. The parameters showing statistically significant association with progression-free survival included time from diagnosis to the beginning of treatment with TKI<1 year, increased lactate dehydrogenase, and Eastern Oncology Cooperative Group performance status 2 or higher. We have also validated the International Metastatic Renal Cell Carcinoma Database Consortium prognostic model in our cohort of patients.ConclusionWe demonstrate that the International Database Consortium prognostic model performs well for European patients treated with TKIs, including sunitinib or sorafenib, after progression on cytokines and suggest that a reduction from original 6 down to 4 parameters is possible.
Keywords:renal cell carcinoma  prognosis  survival  sunitinib  sorafenib
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