Prognostic significance of C-reactive protein in patients with intermediate-risk metastatic renal cell carcinoma treated with molecular targeted therapy

Teishima, Jun; Kobatake, Kohei; Hayashi, Tetsutaro; Seno, Yasuyuki; Ikeda, Kenichiro; Nagamatsu, Hirotaka; Hieda, Keisuke; Shoji, Koichi; Miyamoto, Kengo; Inoue, Shogo; Kobayashi, Kanao; Ohara, Shuichi; Kajiwara, Mitsuru; Matsubara, Akio

doi:10.3892/ol.2014.2207

Cited by 23 publications

(15 citation statements)

References 30 publications

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“…With regard to the manifold adjuvant and systemic therapies that have been bestowed on our patient cohort over the given time period, we were able to show that preoperative CRP values were predictive over all examined therapy modalities such as immunotherapy and targeted therapy approaches, which is confirmed by the available literature [13][14][15][16]29] .…”

Section: Discussionsupporting

confidence: 65%

Preoperative C-Reactive Protein Values as a Potential Component in Outcome Prediction Models of Metastasized Renal Cell Carcinoma Patients Receiving Cytoreductive Nephrectomy

Kalogirou

Mulfinger²,

Sokolakis³

et al. 2017

Urol Int

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Purpose: To validate preoperative C-reactive protein (CRP) levels as a prognostic marker for survival in a metastasized renal cell carcinoma (mRCC) patient cohort receiving cytoreductive nephrectomy (CN). Patients and Methods: By chart review, 146 mRCC patients receiving CN at our tertiary referral centre from 1997 to 2015 were identified retrospectively. All relevant clinicopathological features including laboratory parameters were collected and correlated to overall survival, progression-free survival and cancer-specific survival (CSS). The mean follow-up was 23 months (range 1-168 months). Results: Besides the already established scoring systems like the MSKCC criteria, an elevated preoperative CRP level (≥0.5 mg/dL) was an independent predictor of CSS in our study group including the chosen postoperative adjuvant therapies (TKI vs. immunotherapy vs. others). With regard to morbidity, patients with a good performance status, small tumour size and adequate renal function/haematopoiesis experienced less complication rates, thereby profiting more from CN. Conclusions: Our data provide indication that preoperative CRP levels should be implemented in nomograms regarding the outcome prediction in mRCC to identify candidates likely to profit from CN.

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Section: Discussionsupporting

confidence: 65%

Preoperative C-Reactive Protein Values as a Potential Component in Outcome Prediction Models of Metastasized Renal Cell Carcinoma Patients Receiving Cytoreductive Nephrectomy

Kalogirou

Mulfinger²,

Sokolakis³

et al. 2017

Urol Int

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“…Patients in the intermediate-risk group with non-elevated pretreatment CRP levels (≤3 mg/L) had an overall survival that was significantly increased compared to those with elevated pretreatment CRP levels (>3 mg/L). The 1-, 2-, and 3-year overall survival was of 91.3%, 69.3%, and 62.3% for the patients with non-elevated CRP levels and 56.5%, 38.7%, and 24.6% for the patients with elevated CRP levels (p < 0.0001) (Teishima et al, 2014).…”

Section: Renal Cell Carcinomamentioning

confidence: 98%

C-reactive protein in urologic cancers

Huang

Baum

Alemozaffar

et al. 2015

Molecular Aspects of Medicine

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“…CRP has been shown to be a non-specific biomarker in patients with various stages of RCC who receive surgery (13-16,18-21), immunotherapy (13,15,17,22,23) and molecular-targeted therapy (9)(10)(11)(12). CRP has a promising role in predicting survival among patients with localized and metastatic RCC.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have revealed a prognostic role for CRP in the outcome of sunitinib treatment (9)(10)(11)(12). Normal pretreatment CRP levels predict a higher response rate and better survival among patients undergoing sunitinib treatment (9,11).…”

Section: Introductionmentioning

confidence: 99%

Prognostic effect of serum C-reactive protein kinetics on advanced renal cell carcinoma treated with sunitinib

Fujita

Tabata

Ishii

et al. 2017

Molecular and Clinical Oncology

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Abstract. C-reactive protein (CRP) is an independent prognostic factor for renal cell carcinoma (RCC). The aim of the present study was to investigate the prognostic effect of pretreatment serum CRP level and CRP kinetics on patients with advanced RCC treated with sunitinib. A total of 56 consecutive patients with advanced RCC treated with sunitinib between December, 2008 and December, 2012 were enrolled in the present study. The patients were retrospectively divided into 3 cohorts according to pretreatment serum CRP level and CRP kinetics: i) Normal CRP cohort (pretreatment CRP ≤0.30 mg/dl); ii) normalized CRP cohort (pretreatment CRP >0.30 mg/dl that normalized within 2 cycles of treatment); and iii) non-normalized CRP cohort (pretreatment CRP >0.30 mg/dl that did not normalize after sunitinib initiation). Disease control rate, progression-free survival and overall survival times were compared for the 3 cohorts. The normal (n=17, 30.4%) and the normalized (n=8, 14.3%) CRP cohorts exhibited significantly better disease control rates compared with the non-normalized CRP cohort (n=31, 55.4%; P<0.0001 and P=0.0445, respectively). The normal CRP cohort exhibited significantly longer progression-free survival compared with the non-normalized CRP cohort (P=0.0050). The normal and normalized CRP cohorts exhibited significantly longer overall survival compared with the non-normalized CRP cohort (P=0.0005 and 0.0466, respectively). Therefore, CRP kinetics and normal pretreatment CRP level are prognostic indicators in patients with advanced RCC treated with sunitinib. IntroductionC-reactive protein (CRP), which was found to be a representative acute-phase reactant in 1930, is the most widely used marker of systemic inflammation (1). Inflammation plays an important role during almost all stages of tumor development (2). For example, the proliferation of renal cell carcinoma (RCC) is associated with increased levels of interleukin-6 (IL-6), nuclear factor-κB, and other inflammatory factors (3,4), and the serum CRP levels were found to be correlated with the levels of proinflammatory cytokines, such as IL-6 (5). Numerous studies have demonstrated that CRP is a significant prognostic factor among patients with RCC at various stages, whether they are being treated by surgery, systemic therapy, or both (6).Sunitinib malate (Sutent, Pfizer Inc., New York, NY, USA) is an orally administered, small-molecule, multitargeted inhibitor of tyrosine kinases (e.g., vascular endothelial growth factor receptor, platelet-derived growth factor receptor, phosphorylation of stem cell factor receptor, Fms-like tyrosine kinase-3, colony-stimulating factor-1 receptor, and RET receptor tyrosine kinases). In a phase III clinical trial including patients with advanced RCC, sunitinib achieved significantly better results compared with interferon (IFN)-α and is approved worldwide for the treatment of advanced RCC (7,8). The number of patients treated with sunitinib is increasing and, therefore, there is an urgent need to identify biomarkers that may...

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Prognostic significance of C-reactive protein in patients with intermediate-risk metastatic renal cell carcinoma treated with molecular targeted therapy

Cited by 23 publications

References 30 publications

Preoperative C-Reactive Protein Values as a Potential Component in Outcome Prediction Models of Metastasized Renal Cell Carcinoma Patients Receiving Cytoreductive Nephrectomy

Preoperative C-Reactive Protein Values as a Potential Component in Outcome Prediction Models of Metastasized Renal Cell Carcinoma Patients Receiving Cytoreductive Nephrectomy

C-reactive protein in urologic cancers

Prognostic effect of serum C-reactive protein kinetics on advanced renal cell carcinoma treated with sunitinib

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