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- Title
Urine protein:creatinine ratio vs 24-hour urine protein for proteinuria management: analysis from the phase 3 REFLECT study of lenvatinib vs sorafenib in hepatocellular carcinoma.
- Authors
Evans, Thomas R. Jeffry; Kudo, Masatoshi; Finn, Richard S.; Han, Kwang-Hyub; Cheng, Ann-Lii; Ikeda, Masafumi; Kraljevic, Silvija; Ren, Min; Dutcus, Corina E.; Piscaglia, Fabio; Sung, Max W.
- Abstract
<bold>Background: </bold>Proteinuria monitoring is required in patients receiving lenvatinib, however, current methodology involves burdensome overnight urine collection.<bold>Methods: </bold>To determine whether the simpler urine protein:creatinine ratio (UPCR) calculated from spot urine samples could be accurately used for proteinuria monitoring in patients receiving lenvatinib, we evaluated the correlation between UPCR and 24-hour urine protein results from the phase 3 REFLECT study. Paired data (323 tests, 154 patients) were analysed.<bold>Results: </bold>Regression analysis showed a statistically significant correlation between UPCR and 24-hour urine protein (R2: 0.75; P < 2 × 10-16). A UPCR cut-off value of 2.4 had 96.9% sensitivity, 82.5% specificity for delineating between grade 2 and 3 proteinuria. Using this UPCR cut-off value to determine the need for further testing could reduce the need for 24-hour urine collection in ~74% of patients.<bold>Conclusion: </bold>Incorporation of UPCR into the current algorithm for proteinuria management can enable optimisation of lenvatinib treatment, while minimising patient inconvenience.<bold>Clinical Trial Registration: </bold>NCT01761266.
- Publication
British Journal of Cancer, 2019, Vol 121, Issue 3, p218
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-019-0506-6