First-line axitinib therapy is less effective in metastatic renal cell carcinoma with spindle histology

被引：2

作者：

Numakura, Kazuyuki ^{[1
]}

Kobayashi, Mizuki ^{[1
]}

Muto, Yumina ^{[1
]}

Sekine, Yuya ^{[1
]}

Takahashi, Makoto ^{[1
]}

Kashima, Soki ^{[1
]}

Yamamoto, Ryohei ^{[1
]}

Koizumi, Atsushi ^{[1
]}

Nara, Taketoshi ^{[1
]}

Saito, Mitsuru ^{[1
]}

Narita, Shintaro ^{[1
]}

Nanjyo, Hiroshi ^{[2
]}

Habuchi, Tomonori ^{[1
]}

机构：

[1] Akita Univ, Dept Urol, Grad Sch Med, 1-1-1 Hondo, Akita 0108543, Japan

[2] Akita Univ Hosp, Div Pathol, Akita, Japan

来源：

SCIENTIFIC REPORTS | 2020年 / 10卷 / 01期

关键词：

SUNITINIB; SURVIVAL; INHIBITORS; SORAFENIB; EFFICACY;

D O I：

10.1038/s41598-020-77135-6

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Axitinib, a vascular endothelial growth factor receptor-tyrosine kinase inhibitor, will be used in combination first-line therapies against metastatic renal cell carcinoma (mRCC), but its effects as a first-line monotherapy are unclear. Thus, we aimed to elucidate pretreatment clinical factors that predict the prognosis of patients with mRCC receiving first-line axitinib therapy. We enrolled 63 patients with mRCC treated with axitinib as first-line therapy between Nov. 2003 and Jul. 2018. Progression-free survival (PFS) and overall survival (OS) were assessed using the Wald chi (2) statistic in Cox proportional hazards regression. Median patient age was 67 (range: 25-85) years. Seven (11.1%) patients were classified as being at favorable risk, 33 (52.4%) at intermediate risk, and 23 (36.5%) at poor risk according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk classification system. Median follow-up duration after axitinib initiation was 14 (range: 1-72) months. Median PFS and OS were 18 months and 65 months, respectively. Cox regression analyses of clinical predictors revealed that high C-reactive protein (CRP) levels were significantly correlated with shorter PFS [hazard ratio (HR), 1.63; 95% confidence interval (CI) 1.7-4.0)], whereas spindle cells and poor IMDC risk scores were related to worse OS (HR, 2.87 and 2.88, respectively; 95% CI 1.4-11.0 and 1.1-8.5, respectively). Thus, patients with mRCC and spindle histology or poor IMDC risk scores had worse OS, and those with high CRP levels had shorter PFS in first-line axitinib treatment. Other therapies might be more suitable for initial management of such patients.

引用

页数：7

共 29 条

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