PURPOSE: Several prognostic models have been proposed for metastatic renal cell carcinoma (mRCC) but none has been validated in patients receiving third-line targeted agents. We aim to evaluate the prognostic factors in patients affected by mRCC who received a third-line of targeted agent. MATERIALS AND METHODS: Data about 2,065 patients affected by clear cell mRCC and treated with targeted therapies in 23 centres in Italy were retrospectively reviewed. A total of 281 patients treated with three targeted agents were included in the final analysis. Overall survival (OS) was the main outcome. Cox proportional hazards regression, followed by bootstrap validation, was used to identify independent prognostic factors. RESULTS: Three clinical characteristics (ECOG-PS >1, presence of metastases at diagnosis, and presence of liver metastases) and two biochemical factors (hemoglobin < LLN and neutrophils > ULN) were found to be prognostic. Patients were classified in three categories of risk based on the presence of zero or one risk factors (low-risk), two risk factors (intermediate-risk) and >2 risk factors (high-risk). The median OS was 19.7, 10.1, and 5.5 months, while the 1-year OS was 71%; 43%, and 15%, respectively. Major limit is the retrospective nature of this study and the absence of external validation. CONCLUSIONS: This nomogram included both clinical and biochemical prognostic factors and it may be useful for selection of patients in clinical trials and for the defining prognosis in clinical practice.
Prognostic factors in patients receiving third-line targeted therapy for metastatic renal cell carcinoma.
BERRUTI, Alfredo;
2015-01-01
Abstract
PURPOSE: Several prognostic models have been proposed for metastatic renal cell carcinoma (mRCC) but none has been validated in patients receiving third-line targeted agents. We aim to evaluate the prognostic factors in patients affected by mRCC who received a third-line of targeted agent. MATERIALS AND METHODS: Data about 2,065 patients affected by clear cell mRCC and treated with targeted therapies in 23 centres in Italy were retrospectively reviewed. A total of 281 patients treated with three targeted agents were included in the final analysis. Overall survival (OS) was the main outcome. Cox proportional hazards regression, followed by bootstrap validation, was used to identify independent prognostic factors. RESULTS: Three clinical characteristics (ECOG-PS >1, presence of metastases at diagnosis, and presence of liver metastases) and two biochemical factors (hemoglobin < LLN and neutrophils > ULN) were found to be prognostic. Patients were classified in three categories of risk based on the presence of zero or one risk factors (low-risk), two risk factors (intermediate-risk) and >2 risk factors (high-risk). The median OS was 19.7, 10.1, and 5.5 months, while the 1-year OS was 71%; 43%, and 15%, respectively. Major limit is the retrospective nature of this study and the absence of external validation. CONCLUSIONS: This nomogram included both clinical and biochemical prognostic factors and it may be useful for selection of patients in clinical trials and for the defining prognosis in clinical practice.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
