Validation of the MSKCC and Heng Risk Criteria Models for Predicting Survival in Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib

Kwon, Whi‐An; Cho, In-Chang; Yu, Ami; Nam, Byung–Ho; Joung, Jae Young; Seo, Ho Kyung; Lee, Kang Hyun; Chung, Jinsoo

doi:10.1245/s10434-013-3290-1

Cited by 33 publications

(32 citation statements)

References 21 publications

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“…To date, the most widely used system is the MSKCC classification model that may facilitate prognostic individualization in mRCC patients who have received systemic therapy (14); however, despite being validated in the era of molecular-targeted therapy (18), this model was developed based on data from patients treated with IFN-α in a clinical trial. To overcome such possible limitations of the MSKCC classification, Heng et al (11) presented a novel model to assess the prognosis of TKI-naive mRCC patients treated with VEGF-targeted agents in routine clinical practice.…”

Section: Univariate Analysis Multivariate Analysis ------------------mentioning

confidence: 99%

Prognostic outcome in patients treated with tyrosine kinase inhibitors as first-line molecular-targeted therapy for metastatic renal cell carcinoma: Experience in real-world clinical practice in Japan

Miyazaki

Harada

Inoue

et al. 2015

Molecular and Clinical Oncology

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Abstract. The aim of this study was to evaluate the oncological efficacy of tyrosine kinase inhibitors (TKIs) as first-line molecular-targeted therapy for Japanese patients with metastatic renal cell carcinoma (mRCC) in a routine clinical setting. This study included a total of 271 consecutive Japanese patients with TKI-naive mRCC, including 172 patients who received sorafenib and 99 who received sunitinib for ≥2 months as a first-line molecular-targeted agent. The prognostic outcomes of these patients were retrospectively assessed. During the observation period (median, 19 months), 126 patients (46.5%) succumbed to the disease and the median overall survival (OS) for the entire cohort was 33.1 months. The univariate analysis identified the Memorial Sloan-Kettering Cancer Center (MSKCC) classification, C-reactive protein (CRP) level, lymph node metastasis, bone metastasis, liver metastasis, histological subtype and sarcomatoid characteristics as significant predictors of OS. Of these factors, only the MSKCC classification, CRP level and liver metastasis were found to be independently associated with OS in the multivariate analysis. Furthermore, there were significant differences in OS according to the positivity for these 3 independent risk factors (i.e., negative for all factors vs. positive for a single factor vs. positive for 2 or 3 factors). These findings suggest that the introduction of TKIs as first-line molecular-targeted agents resulted in favorable cancer control outcomes in Japanese mRCC patients and that the prognosis of these patients may be stratified by 3 potential parameters, including the MSKCC classification, CRP level and liver metastasis.

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Section: Univariate Analysis Multivariate Analysis ------------------mentioning

confidence: 99%

Prognostic outcome in patients treated with tyrosine kinase inhibitors as first-line molecular-targeted therapy for metastatic renal cell carcinoma: Experience in real-world clinical practice in Japan

Miyazaki

Harada

Inoue

et al. 2015

Molecular and Clinical Oncology

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“…The importance of prognostic models was well defined and widely used to predict the results of VEGF-targeted therapy. 12,21 According to the above-mentioned reports, the hazards ratio for OS increased from favorable risk criteria to poor risk criteria. Second, the number of patients who had undergone nephrectomy was low in this study.…”

Section: Discussionmentioning

confidence: 99%

“…According to Kwon et al, the Heng model had slightly better discriminatory ability than the MSKCC model for Korean patients. 21 Therefore, the present study applied the Heng model to classify each patient.…”

Section: Cuaj -Original Researchmentioning

confidence: 99%

Clinical outcomes of the sequential use of pazopanib followed by everolimus for the treatment of metastatic renal cell carcinoma: A multicentre study in Korea

Kim

Lee

Kim

et al. 2017

CUAJ

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Introduction: The aim of this study was to investigate the real-world clinical outcomes of first-line pazopanib and second-line everolimus in Korean patients with metastatic renal cell carcinoma (mRCC). Methods: Data of patients who had mRCC with clear-cell component between 2001 and 2015 at multiple institutions were collected retrospectively. To be included in the analysis, patients had to meet the following criteria: age≥18 years; received first-line targeted therapy with pazopanib; and received second-line targeted therapy with everolimus. The primary outcomes included overall survival (OS), progression-free survival (PFS), and adverse events (AEs). Results: A total of 36 patients were included in the analysis. The median followup period was 33.5 months (range 17-49.5). The median PFS was eight months (95% confidence interval [CI] 6.4-9.6) after treatment with pazopanib and three months (95% CI 1.9-4.1) with everolimus. The median OS was 27 months (95% CI 16.6-37.4). The median treatment duration was seven months (range 4.3-10.8) after treatment with pazopanib and 3.5 months (range 3-4) with everolimus. Multivariate analysis revealed that the Heng risk criteria were independently associated with OS (p<0.001). Almost every patient experienced some form of AE, the majority of which were mostly mild or moderate in severity. The most common AEs were diarrhea (50%), hypertension (44.4%), and fatigue (41.7%) after treatment with pazopanib, and anemia (47.2%), stomatitis (41.7%), and fatigue (38.9%) with everolimus. Conclusions: The outcomes for the patients treated with pazopanib followed by everolimus in Korea as observed by us were consistent with those reported by previous studies. The Heng risk criteria were significantly associated with the prognosis of patients with mRCC. AEs were mainly mild to moderate and readily managed.

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“…At present, the most widely used system is the MSKCC classification, which may facilitate prognostic individualization in mRCC patients who received systemic therapy (11). However, despite being validated in the era of molecular-targeted therapy (20), this model was developed based on data from patients treated with IFN-α in a clinical trial. Therefore, there is a need for a system that allows for a more precise assessment of the prognostic risk in patients with mRCC receiving molecular-targeted therapy, since such a tool would be useful for counseling patients, evaluating therapeutic options and planning treatment.…”

Section: Discussionmentioning

confidence: 99%

Progression-free survival of first-line treatment with molecular-targeted therapy may be a meaningful intermediate endpoint for overall survival in patients with metastatic renal cell carcinoma

Furubayashi

Negishi

Yamashita

et al. 2017

Molecular and Clinical Oncology

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Abstract. The aim of the present study was to investigate the association between clinical parameters and the overall survival (OS) of Japanese patients with metastatic renal cell carcinoma (mRCC). The medical records of 59 consecutive mRCC patients receiving molecular-targeted therapy were retrospectively assessed. Kaplan-Meier and log-rank analyses were used to evaluate the progression-free survival (PFS) and OS, and a multivariate Cox

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Validation of the MSKCC and Heng Risk Criteria Models for Predicting Survival in Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib

Abstract: The MSKCC and Heng model were both valid models for predicting OS. The no nephrectomy, no hypertension at baseline, and high C-reactive protein levels were independently associated with poorer OS.

Cited by 33 publications

References 21 publications

Prognostic outcome in patients treated with tyrosine kinase inhibitors as first-line molecular-targeted therapy for metastatic renal cell carcinoma: Experience in real-world clinical practice in Japan

Prognostic outcome in patients treated with tyrosine kinase inhibitors as first-line molecular-targeted therapy for metastatic renal cell carcinoma: Experience in real-world clinical practice in Japan

Clinical outcomes of the sequential use of pazopanib followed by everolimus for the treatment of metastatic renal cell carcinoma: A multicentre study in Korea

Progression-free survival of first-line treatment with molecular-targeted therapy may be a meaningful intermediate endpoint for overall survival in patients with metastatic renal cell carcinoma

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