Clinical outcome predictors for metastatic renal cell carcinoma: a retrospective multicenter real-life case series.
Humans
Carcinoma, Renal Cell
/ drug therapy
Male
Female
Retrospective Studies
Kidney Neoplasms
/ pathology
Aged
Middle Aged
Prognosis
Adult
Treatment Outcome
Immune Checkpoint Inhibitors
/ therapeutic use
Protein Kinase Inhibitors
/ therapeutic use
Aged, 80 and over
Nephrectomy
Kaplan-Meier Estimate
Immunotherapy
Prognosis
Real-world data
Renal cell carcinoma
Targeted therapy
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
05 Jul 2024
05 Jul 2024
Historique:
received:
28
09
2023
accepted:
27
06
2024
medline:
6
7
2024
pubmed:
6
7
2024
entrez:
5
7
2024
Statut:
epublish
Résumé
Over the last decades, the therapeutic armamentarium of metastatic renal cell carcinoma (mRCC) has been revolutionized by the advent of tyrosin-kinase inhibitors (TKI), immune-checkpoint inhibitors (ICI), and immune-combinations. RCC is heterogeneous, and even the most used validated prognostic systems, fail to describe its evolution in real-life scenarios. Our aim is to identify potential easily-accessible clinical factors and design a disease course prediction system. Medical records of 453 patients with mRCC receiving sequential systemic therapy in two high-volume oncological centres were reviewed. The Kaplan-Meier method and Cox proportional hazard model were used to estimate and compare survival between groups. As first-line treatment 366 patients received TKI monotherapy and 64 patients received ICI, alone or in combination. The mean number of therapy lines was 2.5. A high Systemic Inflammation Index, a BMI under 25 Kg/m2, the presence of bone metastases before systemic therapy start, age over 65 years at the first diagnosis, non-clear-cell histology and sarcomatoid component were correlated with a worse OS. No significant OS difference was observed between patients receiving combination therapies and those receiving exclusively monotherapies in the treatment sequence. Our relapse prediction system based on pathological stage and histological grade was effective in predicting the time between nephrectomy and systemic treatment. Our multicentric retrospective analysis reveals additional potential prognostic factors for mRCC, not included in current validated prognostic systems, suggests a model for disease course prediction and describes the outcomes of the most common therapeutic strategies currently available.
Identifiants
pubmed: 38970009
doi: 10.1186/s12885-024-12572-4
pii: 10.1186/s12885-024-12572-4
doi:
Substances chimiques
Immune Checkpoint Inhibitors
0
Protein Kinase Inhibitors
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
804Informations de copyright
© 2024. The Author(s).
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