Skip to main content
Top
Published in: International Journal of Clinical Oncology 5/2013

01-10-2013 | Original Article

Prognostic impact of pretreatment C-reactive protein for patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors

Authors: Yosuke Yasuda, Kazutaka Saito, Takeshi Yuasa, Shinichi Kitsukawa, Shinji Urakami, Shinya Yamamoto, Junji Yonese, Shunji Takahashi, Iwao Fukui

Published in: International Journal of Clinical Oncology | Issue 5/2013

Login to get access

Abstract

Background

C-reactive protein (CRP) was an independent prognostic factor for metastatic renal cell carcinoma in the cytokine era. However, the impact of CRP on the survival of metastatic renal cell carcinoma patients treated with tyrosine kinase inhibitors has not yet been investigated. Therefore, we further evaluated the prognostic impact of CRP for patients with metastatic renal cell carcinoma treated with molecular-targeted agents of tyrosine kinase inhibitors.

Methods

Fifty-two patients were treated with tyrosine kinase inhibitors for metastatic renal cell carcinoma at our institution. Overall, 31 and 21 patients were administered sunitinib and sorafenib, respectively. The prognostic value of all variables, including CRP, for overall survival was assessed using the Cox proportional hazards model.

Results

The median baseline CRP level was 4.9 mg/l. In multivariate analysis, CRP was an independent predictor for overall survival as both continuous and categorical variable. The median overall survival times of patients with non-elevated CRP concentration (<8 mg/l) were not reached, compared with those of patients with elevated CRP concentration (8 mg/l or greater) of 15.9 months. There was a significant difference in overall survival rates between the two groups, with 1- and 3-year overall survival rates of 92.8 and 69.3 % versus 50.2 and 22.9 % for the non-elevated CRP group and the elevated CRP group (p = 0.003), respectively.

Conclusions

CRP has a significant impact on overall survival of patients with metastatic renal cell carcinoma carcinoma treated with tyrosine kinase inhibitors.
Literature
1.
go back to reference Motzer RJ, Hutson TE, Tomczak P et al (2007) Sunitinib versus interferon alfa in metastatic renal cell carcinoma. N Engl J Med 356:115–124PubMedCrossRef Motzer RJ, Hutson TE, Tomczak P et al (2007) Sunitinib versus interferon alfa in metastatic renal cell carcinoma. N Engl J Med 356:115–124PubMedCrossRef
2.
go back to reference Escudier B, Eisen T, Stadler WM et al (2007) Sorafenib in advanced clear cell renal cell carcinoma. N Engl J Med 356:125–134PubMedCrossRef Escudier B, Eisen T, Stadler WM et al (2007) Sorafenib in advanced clear cell renal cell carcinoma. N Engl J Med 356:125–134PubMedCrossRef
3.
go back to reference Escudier B, Pluzanska A, Koralewski P et al (2007) Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: a randomised, double-blind phase III trial. Lancet 370:2103–2111PubMedCrossRef Escudier B, Pluzanska A, Koralewski P et al (2007) Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: a randomised, double-blind phase III trial. Lancet 370:2103–2111PubMedCrossRef
4.
go back to reference Rini BI, Halabi S, Rosenberg JE et al (2008) CALGB 90206: a phase III trial of bevacizumab plus interferon alfa versus interferon alfa monotherapy in metastatic renal cell carcinoma. Presented at the genitourinary cancers symposium, San Francisco, CA Rini BI, Halabi S, Rosenberg JE et al (2008) CALGB 90206: a phase III trial of bevacizumab plus interferon alfa versus interferon alfa monotherapy in metastatic renal cell carcinoma. Presented at the genitourinary cancers symposium, San Francisco, CA
5.
go back to reference Palmer PA, Vinke J, Philip T et al (1992) Prognostic factors for survival in patients with advanced renal cell carcinoma treated with recombinant interleukin-2. Ann Oncol 3:475–480PubMed Palmer PA, Vinke J, Philip T et al (1992) Prognostic factors for survival in patients with advanced renal cell carcinoma treated with recombinant interleukin-2. Ann Oncol 3:475–480PubMed
6.
go back to reference Negrier S, Escudier B, Gomez F et al (2002) Prognostic factors of survival and rapid progression in 782 patients with metastatic renal carcinomas treated by cytokines: a report from the Groupe Francais d’Immunotherapie. Ann Oncol 13:1460–1468PubMedCrossRef Negrier S, Escudier B, Gomez F et al (2002) Prognostic factors of survival and rapid progression in 782 patients with metastatic renal carcinomas treated by cytokines: a report from the Groupe Francais d’Immunotherapie. Ann Oncol 13:1460–1468PubMedCrossRef
7.
go back to reference Motzer RJ, Bacik J, Murphy BA et al (2002) Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol 20:289–296PubMedCrossRef Motzer RJ, Bacik J, Murphy BA et al (2002) Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol 20:289–296PubMedCrossRef
8.
go back to reference Atzpodien J, Royston P, Wandert T et al (2003) Metastatic renal carcinoma comprehensive prognostic system. Br J Cancer 88:348–353PubMedCrossRef Atzpodien J, Royston P, Wandert T et al (2003) Metastatic renal carcinoma comprehensive prognostic system. Br J Cancer 88:348–353PubMedCrossRef
9.
go back to reference McMillan DC, Canna K, McArdle CS (2003) Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 90:215–219PubMedCrossRef McMillan DC, Canna K, McArdle CS (2003) Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 90:215–219PubMedCrossRef
10.
go back to reference Heys SD, Ogston KN, Simpson WG et al (1998) Acute phase proteins in patients with large and locally advanced breast cancer treated with neo-adjuvant chemotherapy: response and survival. Int J Oncol 13:589–594PubMed Heys SD, Ogston KN, Simpson WG et al (1998) Acute phase proteins in patients with large and locally advanced breast cancer treated with neo-adjuvant chemotherapy: response and survival. Int J Oncol 13:589–594PubMed
11.
go back to reference Guillem P, Triboulet JP (2005) Elevated serum levels of C-reactive protein are indicative of a poor prognosis in patients with esophageal cancer. Dis Esophagus 18:146–150PubMedCrossRef Guillem P, Triboulet JP (2005) Elevated serum levels of C-reactive protein are indicative of a poor prognosis in patients with esophageal cancer. Dis Esophagus 18:146–150PubMedCrossRef
12.
go back to reference Bromwich E, McMillan DC, Lamb GW et al (2004) The systemic inflammatory response, performance status and survival in patients undergoing alpha-interferon treatment for advanced renal cancer. Br J Cancer 91:1236–1238PubMedCrossRef Bromwich E, McMillan DC, Lamb GW et al (2004) The systemic inflammatory response, performance status and survival in patients undergoing alpha-interferon treatment for advanced renal cancer. Br J Cancer 91:1236–1238PubMedCrossRef
13.
go back to reference Casamassima A, Picciariello M, Quaranta M et al (2005) C-reactive protein: a biomarker of survival in patients with metastatic renal cell carcinoma treated with subcutaneous interleukin-2 based immunotherapy. J Urol 173:52–55PubMedCrossRef Casamassima A, Picciariello M, Quaranta M et al (2005) C-reactive protein: a biomarker of survival in patients with metastatic renal cell carcinoma treated with subcutaneous interleukin-2 based immunotherapy. J Urol 173:52–55PubMedCrossRef
14.
go back to reference Ramsey S, Lamb GW, Aitchison M et al (2007) Evaluation of an inflammation-based prognostic score in patients with metastatic renal cancer. Cancer 109:205–212PubMedCrossRef Ramsey S, Lamb GW, Aitchison M et al (2007) Evaluation of an inflammation-based prognostic score in patients with metastatic renal cancer. Cancer 109:205–212PubMedCrossRef
15.
go back to reference Saito K, Tatokoro M, Fujii Y et al (2009) Impact of C-reactive protein kinetics on survival of patients with metastatic renal cell carcinoma. Eur Urol 55:1145–1153PubMedCrossRef Saito K, Tatokoro M, Fujii Y et al (2009) Impact of C-reactive protein kinetics on survival of patients with metastatic renal cell carcinoma. Eur Urol 55:1145–1153PubMedCrossRef
16.
go back to reference Motzer RJ, Bacik J, Schwartz LH et al (2004) Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol 22:454–463PubMedCrossRef Motzer RJ, Bacik J, Schwartz LH et al (2004) Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol 22:454–463PubMedCrossRef
17.
go back to reference Choueiri TK, Garcia JA, Elson P et al (2007) Clinical factors associated with outcome in patients with metastatic clear-cell renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. Cancer 110:543–550PubMedCrossRef Choueiri TK, Garcia JA, Elson P et al (2007) Clinical factors associated with outcome in patients with metastatic clear-cell renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. Cancer 110:543–550PubMedCrossRef
18.
go back to reference Heng DY, Xie W, Regan MM et al (2009) Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol 27:5794–5799PubMedCrossRef Heng DY, Xie W, Regan MM et al (2009) Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol 27:5794–5799PubMedCrossRef
19.
go back to reference Saito K, Kihara K (2010) Role of C-reactive protein as a biomarker for renal cell carcinoma. Expert Rev Anticancer Ther 10:1979–1989PubMedCrossRef Saito K, Kihara K (2010) Role of C-reactive protein as a biomarker for renal cell carcinoma. Expert Rev Anticancer Ther 10:1979–1989PubMedCrossRef
20.
go back to reference Saito K, Kihara K (2011) C-reactive protein as a biomarker for urological cancers. Nat Rev Urol 8:659–666PubMed Saito K, Kihara K (2011) C-reactive protein as a biomarker for urological cancers. Nat Rev Urol 8:659–666PubMed
21.
go back to reference Komai Y, Saito K, Sakai K et al (2007) Increased preoperative serum C-reactive protein level predicts a poor prognosis in patients with localized renal cell carcinoma. BJU Int 99:77–80PubMedCrossRef Komai Y, Saito K, Sakai K et al (2007) Increased preoperative serum C-reactive protein level predicts a poor prognosis in patients with localized renal cell carcinoma. BJU Int 99:77–80PubMedCrossRef
22.
go back to reference Tatokoro M, Saito K, Iimura Y et al (2008) Prognostic impact of postoperative C-reactive protein level in patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy. J Urol 180:515–519PubMedCrossRef Tatokoro M, Saito K, Iimura Y et al (2008) Prognostic impact of postoperative C-reactive protein level in patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy. J Urol 180:515–519PubMedCrossRef
23.
go back to reference Iimura Y, Saito K, Fujii Y et al (2009) Development and external validation of a new outcome prediction model for patients with clear cell renal cell carcinoma treated with nephrectomy based on preoperative serum C-reactive protein and TNM classification: the TNM-C score. J Urol 181:1004–1012PubMedCrossRef Iimura Y, Saito K, Fujii Y et al (2009) Development and external validation of a new outcome prediction model for patients with clear cell renal cell carcinoma treated with nephrectomy based on preoperative serum C-reactive protein and TNM classification: the TNM-C score. J Urol 181:1004–1012PubMedCrossRef
24.
go back to reference Miki S, Iwano M, Miki Y et al (1989) Interleukin-6 (IL-6) functions as an in vitro autocrine growth factor in renal cell carcinomas. FEBS Lett 250:607–610PubMedCrossRef Miki S, Iwano M, Miki Y et al (1989) Interleukin-6 (IL-6) functions as an in vitro autocrine growth factor in renal cell carcinomas. FEBS Lett 250:607–610PubMedCrossRef
25.
go back to reference Koo AS, Armstrong C, Bochner B et al (1992) Interleukin-6 and renal cell cancer: production, regulation, and growth effects. Cancer Immunol Immunother 35:97–105PubMedCrossRef Koo AS, Armstrong C, Bochner B et al (1992) Interleukin-6 and renal cell cancer: production, regulation, and growth effects. Cancer Immunol Immunother 35:97–105PubMedCrossRef
Metadata
Title
Prognostic impact of pretreatment C-reactive protein for patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors
Authors
Yosuke Yasuda
Kazutaka Saito
Takeshi Yuasa
Shinichi Kitsukawa
Shinji Urakami
Shinya Yamamoto
Junji Yonese
Shunji Takahashi
Iwao Fukui
Publication date
01-10-2013
Publisher
Springer Japan
Published in
International Journal of Clinical Oncology / Issue 5/2013
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-012-0454-0

Other articles of this Issue 5/2013

International Journal of Clinical Oncology 5/2013 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine