Is Late Recurrence a Predictive Clinical Marker for Better Sunitinib Response in Metastatic Renal Cell Carcinoma Patients?

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Abstract

Micro-Abstract

Although there has been an increase in overall and progression-free survival with the use of novel targeted therapies in metastatic renal cell carcinoma (mRCC) in recent times, predictive markers to determine which patients would benefit from tyrosine kinase inhibitor therapies are needed. The late recurrence might be a predictive marker for response to sunitinib treatment in patients with mRCC.

Background:

We investigated the clinicopathological features in patients with recurrent renal cell carcinoma (RCC) within 5 years or more than 5 years after nephrectomy and determined predictors of overall survival (OS) and progression-free survival (PFS) after disease recurrence in the administration of first-line sunitinib in the treatment of metastatic RCC (mRCC).

Patients and Methods:

In this study we enrolled 86 Turkish patients with mRCC who received sunitinib. Univariate analyses were performed using the log rank test.

Results:

Fifty-six patients (65%) were diagnosed with disease recurrence within 5 years after radical nephrectomy (early recurrence) and 30 patients (35%) were diagnosed with recurrence more than 5 years after radical nephrectomy (late recurrence). Fuhrman grade was statistically significantly different between the 2 groups (P = .013). The late recurrence patients were significantly associated with the Memorial Sloan Kettering Cancer Center favorable risk group compared with patients with early recurrence (P = .001). There was a statistically significant correlation between recurrence time and the rate of objective remission (ORR) (the late recurrence group vs. the early recurrence group: 43.3% vs. 14.3%, respectively; P = .004). From the time of disease recurrence, the median OS was 42.0 (95% confidence interval [CI], 24.4–59.5) months in the late recurrence group, and 16 (95% CI, 11.5–20.4) months in the early recurrence group (P = .001). Median PFS was 8 (95% CI, 4.05–11.9) months in the early recurrence group, and 20 (95% CI, 14.8–25.1) months in the late recurrence group (P ≤ .001).

Conclusion:

The study demonstrated a potential prognostic value of late recurrence in terms of PFS, OS, and ORR.

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