C-反应蛋白早期反应作为酪氨酸激酶抑制剂治疗转移性肾细胞癌患者生存预测指标。
Early response of C-reactive protein as a predictor of survival in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors.
机构信息
Department of Urology, Tokyo Medical and Dental University, Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
Department of Urology, Cancer Institute Hospital Japanese Foundation for Cancer Research, Tokyo, Japan.
出版信息
Int J Clin Oncol. 2017 Dec;22(6):1081-1086. doi: 10.1007/s10147-017-1166-2. Epub 2017 Jul 21.
BACKGROUND
Pretreatment C-reactive protein (CRP) has been shown to be an independent prognostic factor for metastatic renal cell carcinoma (mRCC) treated with tyrosine kinase inhibitors (TKIs). We further evaluated the early response of CRP after the initiation of TKIs.
METHODS
A total of 103 patients (80 men and 23 women) were treated with TKIs for mRCC from 2008-2013. Patients were divided into three groups according to their early CRP kinetics-patients whose baseline CRP levels were <10 mg/L (non-elevated), patients whose baseline CRP levels were ≥10 mg/L and had decreased by >20% at 4 weeks after the initiation of TKIs (early CRP responder), and the remaining patients (non-early CRP responder). The endpoints were progression-free survival (PFS) and overall survival (OS).
RESULTS
The median follow-up period was 21 (interquartile range 10-34) months. The numbers of patients classified as non-elevated, early CRP responder, and non-early CRP responder were 62, 19, and 22, respectively. The 1-year PFS rates of patients in the non-elevated, early CRP responder, and non-early CRP responder groups were 50, 23, and 9.7%, respectively (p < 0.001). The 1-year OS rates of patients in these three groups were 79, 62, and 36%, respectively (p < 0.001). In multivariate analysis, the early CRP kinetics assessment was a significant independent factor for PFS and OS.
CONCLUSIONS
Early CRP response at 4 weeks is predictive of survival for patients with mRCC treated with TKI.
背景
C 反应蛋白（CRP）的预处理水平已被证明是接受酪氨酸激酶抑制剂（TKI）治疗的转移性肾细胞癌（mRCC）的独立预后因素。我们进一步评估了 TKI 治疗开始后 CRP 的早期反应。
方法
2008 年至 2013 年间，共有 103 例（80 名男性和 23 名女性）mRCC 患者接受 TKI 治疗。根据患者的 CRP 动力学，将其分为三组：基线 CRP 水平<10mg/L 的患者（非升高组）、基线 CRP 水平≥10mg/L 且在 TKI 治疗后 4 周下降>20%的患者（早期 CRP 反应组）和其余患者（非早期 CRP 反应组）。终点为无进展生存期（PFS）和总生存期（OS）。
结果
中位随访时间为 21 个月（四分位距 10-34 个月）。非升高组、早期 CRP 反应组和非早期 CRP 反应组患者分别为 62、19 和 22 例。非升高组、早期 CRP 反应组和非早期 CRP 反应组患者的 1 年 PFS 率分别为 50%、23%和 9.7%（p<0.001）。三组患者的 1 年 OS 率分别为 79%、62%和 36%（p<0.001）。多因素分析显示，早期 CRP 动力学评估是 PFS 和 OS 的独立预后因素。
结论
TKI 治疗后 4 周的早期 CRP 反应可预测 mRCC 患者的生存情况。
Zotero 插件