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- Title
Prognostic impact of baseline serum C-reactive protein in patients with metastatic renal cell carcinoma ( RCC) treated with sunitinib.
- Authors
Beuselinck, Benoit; Vano, Yann‐Alexandre; Oudard, Stéphane; Wolter, Pascal; De Smet, Robert; Depoorter, Lore; Teghom, Corine; Karadimou, Alexandra; Zucman‐Rossi, Jessica; Debruyne, Philip R.; Van Poppel, Hendrik; Joniau, Steven; Lerut, Evelyne; Strijbos, Michiel; Dumez, Herlinde; Paridaens, Robert; Van Calster, Ben; Schöffski, Patrick
- Abstract
Objective To evaluate the impact of baseline serum C-reactive protein ( CRP) level on outcome in patients with metastatic renal cell carcinoma ( mRCC) treated with sunitinib., Patients and Methods We reviewed the charts of patients with mRCC who started sunitinib as a first targeted treatment between 2005 and 2012 in three hospitals in Belgium and France., Collected data included known prognostic factors for mRCC, anatomical location of metastatic sites, response rate ( RR), progression-free survival ( PFS) and overall survival ( OS)., Results A total of 200 eligible patients were identified by retrospective chart review. The median PFS and OS were 12 and 20 months, respectively., We observed a clear impact of baseline CRP levels on outcome: the median PFS was 25 months in the group with baseline CRP ≤5 mg/L and 8 months in the group with baseline CRP >5 mg/L (hazard ratio [ HR] 2.48, 95% CI 1.74-3.59). The median OS in each group was 50 vs 12 months, respectively ( HR 3.17, 2.20-4.68). In the group with baseline CRP ≤5 mg/L, 61% of patients experienced a partial response compared with 32% of patients in the group with baseline CRP >5 mg/L (difference = 29%, 95% CI 15-42)., When adding baseline CRP (with a log transformation) to the six variables of the International Metastatic RCC Database Consortium ( IMDC) model in a multivariable Cox regression model, baseline CRP was independently associated with poor PFS ( HR for each doubling in CRP level: 1.14, 95% CI 1.03-1.26; P = 0.01) and OS ( HR: 1.29, 95% CI 1.16-1.43; P < 0.001)., Adding baseline CRP to the model increased the c-statistic of PFS at 5 years from 0.63 (0.59-0.68) to 0.69 (0.65-0.73), and the c-statistic of OS at 5 years from 0.65 (0.60-0.69) to 0.70 (0.66-0.74)., Patients with elevated baseline CRP levels had a poor prognosis independent of the IMDC risk group, whereas patients with a low baseline CRP in the IMDC favourable risk group had a very good outcome., Conclusion Baseline serum CRP level is a strong independent variable linked with RR, PFS and OS in patients with mRCC treated with sunitinib.
- Subjects
C-reactive protein; RENAL cell carcinoma; HEALTH outcome assessment; SERUM; METASTASIS; RESPONSE rates
- Publication
BJU International, 2014, Vol 114, Issue 1, p81
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/bju.12494