一项针对接受一线靶向治疗的转移性肾细胞癌患者无进展生存期意外延长或缩短以及总生存期的预测因素的回顾性研究。
A retrospective study of predictive factors for unexpectedly prolonged or shortened progression-free survival and overall survival among patients with metastatic renal cell carcinoma who received first-line targeted therapy.
作者信息
Kim Sung Han, Kim Sohee, Joo Jungnam, Seo Ho Kyung, Joung Jae Young, Lee Kang Hyun, Chung Jinsoo
机构信息
Department of Urology, Center for Prostate Cancer, Hospital of National Cancer Center National Cancer Center, Goyang, Korea.
Biometric Research Branch, Clinical Research Coordination Center, Hospital of National Cancer Center National Cancer Center, Goyang, Korea.
出版信息
BMC Cancer. 2016 Aug 2;16:577. doi: 10.1186/s12885-016-2615-4.
BACKGROUND
To identify predictors of prolonged or shortened progression-free survival (PFS) and overall survival (OS) among patients with metastatic renal cell carcinoma (mRCC) who received first-line targeted therapies.
METHODS
This retrospective study included 146 patients with mRCC who were treated during 2007-2015. These patients were divided into a group with the worst response (WG), an expected group (EG), and a group with the best response (BG), based on their PFS (≤3 monthsnths, 3-18 monthsnths, and >18 monthsnths, respectively) and OS (<1 year, 1-3 years, and >3 years, respectively). To identify significant predictive factors, the BG and WG were compared to the EG using the Memorial Sloan Kettering Cancer Center and Heng risk models.
RESULTS
The overall PFS and OS were 9.3 months and 16.4 months, respectively. The median PFS for the WG (41.8 %), EG (45.9 %), and BG (12.3 %) were 2.7 months, 9.3 months, and 56.6 months, respectively, and the median OS for the WG (45.9 %), EG (35.6 %), and BG (18.5 %) were 5.5 months, 21.6 months, and 63.1 months, respectively; these outcomes were significantly different (p < 0.001). Nephrectomy (odds ratio [OR]: 7.15) was a significant predictor of PFS in the BG, and the significant predictors of OS in the BG were MSKCC intermediate risk (OR: 0.12), poor risk (OR: 0.04), and a disease-free interval of <1 year (OR: 0.23) (all, p < 0.05). Anemia (OR: 3.25) was a significant predictor of PFS in the WG, and the significant predictors of OS were age (OR: 1.05), anemia (OR: 4.13), lymphocytopenia (OR: 4.76), disease-free interval of <1 year (OR: 4.8), and synchronous metastasis (OR: 3.52) (all, p < 0.05).
CONCLUSION
We identified several significant predictors of unexpectedly good and poor response to first-line targeted therapy among patients with mRCC.
背景
确定接受一线靶向治疗的转移性肾细胞癌（mRCC）患者无进展生存期（PFS）延长或缩短以及总生存期（OS）的预测因素。
方法
这项回顾性研究纳入了2007年至2015年期间接受治疗的146例mRCC患者。根据其PFS（分别为≤3个月、3 - 18个月和>18个月）和OS（分别为<1年、1 - 3年和>3年），将这些患者分为反应最差组（WG）、预期组（EG）和反应最佳组（BG）。为了确定显著的预测因素，使用纪念斯隆凯特琳癌症中心和恒风险模型将BG组和WG组与EG组进行比较。
结果
总体PFS和OS分别为9.3个月和16.4个月。WG组（41.8%）、EG组（45.9%）和BG组（12.3%）的中位PFS分别为2.7个月、9.3个月和56.6个月，WG组（45.9%）、EG组（35.6%）和BG组（18.5%）的中位OS分别为5.5个月、21.6个月和63.1个月；这些结果有显著差异（p < 0.001）。肾切除术（优势比[OR]：7.15）是BG组PFS的显著预测因素，BG组OS的显著预测因素是纪念斯隆凯特琳癌症中心（MSKCC）中度风险（OR：0.12）、低风险（OR：0.04）和无病间期<1年（OR：0.23）（均p < 0.05）。贫血（OR：3.25）是WG组PFS的显著预测因素，OS的显著预测因素是年龄（OR：1.05）、贫血（OR：4.13）、淋巴细胞减少（OR：4.76）、无病间期<1年（OR：4.8）和同时性转移（OR：3.52）（均p < 0.05）。
结论
我们确定了mRCC患者对一线靶向治疗反应出乎意料地好和差的几个显著预测因素。
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