Prognostic factors for survival in 1059 patients treated with sunitinib for metastatic renal cell carcinoma

Abstract

Background:Prognostic factors for progression-free survival (PFS), overall survival (OS), and long-term OS (⩾30 months) were investigated in sunitinib-treated patients with metastatic renal cell carcinoma (RCC).Methods:Data were pooled from 1059 patients in six trials. Baseline variables, including ethnicity, were analysed for prognostic significance by Cox proportional-hazards model.Results:Median PFS and OS were 9.7 and 23.4 months, respectively. Multivariate analysis of PFS and OS identified independent predictors, including ethnic origin, Eastern Cooperative Oncology Group performance status, time from diagnosis to treatment, prior cytokine use, haemoglobin, lactate dehydrogenase, corrected calcium, neutrophils, platelets, and bone metastases (OS only). Characteristics of long-term survivors (n=215, 20%) differed from those of non-long-term survivors; independent predictors of long-term OS included ethnic origin, bone metastases, and corrected calcium. There were no differences in PFS (10.5 vs 7.2 months; P=0.1006) or OS (23.8 vs 21.4 months; P=0.2135) in white vs Asian patients; however, there were significant differences in PFS (10.5 vs 5.7 months; P<0.001) and OS (23.8 vs 17.4 months; P=0.0319) in white vs non-white, non-Asian patients.Conclusion:These analyses identified risk factors to survival with sunitinib, including potential ethnic-based differences, and validated risk factors previously reported in advanced RCC.

Immunotherapy for genitourinary cancer

“…Fifty-two percent of the evaluable patients receiving AGS-003 plus sunitinib showed long-term (>30 months) survival. This figure compares favorably with historical data, which indicate a more than 30-month survival of ∼ 13% in intermediate-risk and poor-risk mRCC patients treated with sunitinib alone [62]. These findings, although biased by the indirect nature of comparison and by a huge difference in the numbers of enrolled patients, provided the rationale for the ADAPT trial.…”

RANK/OPG ratio of expression in primary clear-cell renal cell carcinoma is associated with bone metastasis and prognosis in patients treated with anti-VEGFR-TKIs

“…RR on sunitinib was 35% and 55%, respectively (Beuselinck et al, 2011). The impact of the presence of BM on RR and/or mOS was confirmed in subsequent publications (Patil et al, 2011;Motzer et al, 2013;McKay et al, 2014).…”

Axitinib Versus Sorafenib in First-Line Metastatic Renal Cell Carcinoma: Overall Survival From a Randomized Phase III Trial

“…Within each treatment arm, median OS was longer in patients with ECOG PS 0 versus ECOG PS 1 (axitinib, 41.2 vs. 14.2 months; sorafenib, 31.9 vs. 19.8 months). Although ECOG PS is one of the prognostic factors identified and OS in patients with RCC treated with VEGF pathway-targeted tyrosine kinase inhibitors (TKIs),3 it is somewhat subjective in nature. It is unclear if the results of the ECOG PS subgroup analyses here indicate a preferential effect of axitinib over sorafenib in patients with more favorable prognosis, and further investigation is warranted.The actual median OS for axitinib (21.7 months) in this study was shorter than predicted (27 months), whereas actual median OS for sorafenib (23.3 months) was longer than predicted (17 months).…”