Kawai Y, Osawa T, Kobayashi K, Inoue R, Yamamoto Y, Matsumoto H, Nagao K, Hara T, Sakano S, Nagamori S, Matsuyama H
Department of Urology, Yamaguchi University, Ube, Yamaguchi, Japan E-mail :
Asian Pac J Cancer Prev. 2015;16(14):5687-90. doi: 10.7314/apjcp.2015.16.14.5687.
Factors predictive of survival have been identified in Western patients with metastatic clear cell renal cell carcinoma (mCCRCC) treated with sunitinib. Less is known, however, about factors predictive of survival in Japanese patients. This study evaluated factors prognostic of survival in Japanese patients with mCCRCC treated with first-line sunitinib.
This retrospective study evaluated 46 consecutive Japanese mCCRCC patients treated with sunitinib as first line therapy. Clinical and biochemical markers associated with progression-free survival (PFS) were analyzed, with prognostic factors selected by uni- and multivariate Cox regression analyses.
Univariate analysis showed that factors significantly associated with poor PFS included Memorial Sloan-Kettering Cancer Center poor risk scores, International Metastatic RCC Database Consortium poor risk and high (>0.5 mg/dl) serum C-reactive protein (CRP) concentrations (p<0.001 each). Multivariate analysis showed that high serum CRP was independently associated with poorer PFS (p=0.040). Six month disease control rate (complete response, partial response and stable disease) in response to sunitinib was significantly higher in patients with normal (≤0.5 mg/dl) than elevated baseline CRP (p<0.001).
CRP is a significant independent predictor of PFS for Japanese patients with mCCRCC treated with first-line sunitinib. Pretreatment CRP concentration may be a useful biomarker predicting response to sunitinib treatment.
在接受舒尼替尼治疗的西方转移性透明细胞肾细胞癌（mCCRCC）患者中，已确定了生存预测因素。然而，对于日本患者的生存预测因素了解较少。本研究评估了一线接受舒尼替尼治疗的日本mCCRCC患者的生存预后因素。
这项回顾性研究评估了46例连续接受舒尼替尼一线治疗的日本mCCRCC患者。分析了与无进展生存期（PFS）相关的临床和生化指标，并通过单因素和多因素Cox回归分析选择预后因素。
单因素分析显示，与PFS较差显著相关的因素包括纪念斯隆凯特琳癌症中心不良风险评分、国际转移性肾细胞癌数据库联盟不良风险以及血清C反应蛋白（CRP）浓度高（>0.5mg/dl）（各p<0.001）。多因素分析显示，血清CRP高与PFS较差独立相关（p=0.040）。基线CRP正常（≤0.5mg/dl）的患者对舒尼替尼的6个月疾病控制率（完全缓解、部分缓解和病情稳定）显著高于基线CRP升高的患者（p<0.001）。
CRP是一线接受舒尼替尼治疗的日本mCCRCC患者PFS的重要独立预测因素。治疗前CRP浓度可能是预测舒尼替尼治疗反应的有用生物标志物。
