Department of Medical Oncology, Hospital Universitario Central de Asturias, C/ Celestino Villamil s/n, 33006, Oviedo, Asturias, Spain.
Invest New Drugs. 2012 Dec;30(6):2443-9. doi: 10.1007/s10637-012-9836-4. Epub 2012 May 27.
The analysis of predictive factors of response may aid in predicting which patients with advanced renal cell carcinoma (RCC) would be good candidates for systemic treatments.
The expression of several biomarkers was retrospectively analyzed using immunohistochemistry (IHC), as well as 2 analytical variables in 135 patients with advanced RCC treated with cytokines (CK) and/or new targeted drugs (NTD).
67 patients were treated solely with NTD and 68 with CK (23 also received NTD). Univariate analysis: HIF1α did not correlate significantly with response to these drugs. Overexpression of CAIX was associated with more responses (%) to NTD (64.7 vs. 21.1; p = 0.004) and CK (22.6 vs. 0; p = 0.038). PTEN demonstrated predictive value of response to sunitinib (70.8 vs. 34.1; p = 0.005). p21 was associated with a lower response to sunitinib (35.9 vs. 65.4; p = 0.025). Thrombocytosis was not significantly associated with response to NTD, although it was with CK (0 vs. 20; p = 0.017). Neutrophilia correlated with a lower response to NTD (29.6 vs. 57.5; p = 0.045), although not with CK. Multivariate analysis: Overexpression of CAIX was an independent predictor of significantly higher response to NTD and CK; OR = 8.773 (p < 0.001).
Our findings highlight the usefulness of CAIX in selecting patients with advanced RCC as candidates for systemic treatment. PTEN and p21 may be important in predicting response to sunitinib. Thrombocytosis and neutrophilia correlate well with response to CK and NTD, respectively.
分析预测反应的因素可能有助于预测哪些晚期肾细胞癌（RCC）患者是全身性治疗的良好候选者。
使用免疫组织化学（IHC）回顾性分析了几种生物标志物的表达情况，以及 135 名接受细胞因子（CK）和/或新型靶向药物（NTD）治疗的晚期 RCC 患者的 2 个分析变量。
67 名患者仅接受 NTD 治疗，68 名患者接受 CK 治疗（23 名患者也接受 NTD 治疗）。单因素分析：HIF1α 与这些药物的反应无显著相关性。CAIX 过表达与 NTD（64.7%比 21.1%；p=0.004）和 CK（22.6%比 0%；p=0.038）的反应率更高相关。PTEN 对舒尼替尼的反应具有预测价值（70.8%比 34.1%；p=0.005）。p21 与舒尼替尼的反应率较低相关（35.9%比 65.4%；p=0.025）。血小板增多症与 NTD 的反应无显著相关性，但与 CK 相关（0%比 20%；p=0.017）。中性粒细胞增多与 NTD 的反应较低相关（29.6%比 57.5%；p=0.045），但与 CK 无关。多因素分析：CAIX 过表达是 NTD 和 CK 显著高反应的独立预测因子；OR=8.773（p<0.001）。
我们的研究结果强调了 CAIX 在选择晚期 RCC 患者作为全身治疗候选者方面的重要性。PTEN 和 p21 可能在预测舒尼替尼的反应方面很重要。血小板增多症和中性粒细胞增多分别与 CK 和 NTD 的反应密切相关。
