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MP16-10: The impact of kinetics of biomarkers on the prediction of overall survival in patients with metastatic renal cell carcinoma treated with a tyrosine kinase inhibitor.

Friday, May 12
1:00 PM - 3:00 PM
Location: BCEC: Room 253AB

Presentation Authors: Jun Teishima*, Shinya Ohara, Kousuke Sadahide, Shinsuke Fujii, Hiroyuki Kitano, Shunsuke Shinmei, Keisuke Hieda, Shogo Inoue, Tetsutaro Hayashi, Koji Mita, Akio Matsubara, Hiroshima, Japan

Introduction: Our present study aimed to investigate the impact of kinetics of biomarkers on the prediction of overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) treated with a tyrosine kinase inhibitor (TKI).

Methods: Biomarkers including C-reactive protein (CRP), neutrophil count (Neu), neutrophil-lymphocyte ratio (NLR), platelet count (Plt), hemoglobin (Hb), serum lactate dehydrogenase (LDH), and serum albumin (Alb) in 118 cases of molecular targeted therapy for mRCC were measured before the first-line targeted agents started to be prescribed and at the first CT scan during treatment. All cases were classified into higher and lower biomarker groups in accordance with their data when treatments started. All groups were further classified into two subgroups on the basis of the kinetics of all biomarkers after first-line targeted therapy: decreased and non-decreased biomarker subgroups for the higher biomarker groups, or increased and non-increased biomarker subgroups for the lower biomarker groups. All cases were also classified in accordance with their other clinical backgrounds, and the overall survival (OS) of each subgroup was analyzed.

Results: The patients had a median age of 65 years old; and 102 and 16 were diagnosed as having a clear and non-clear cell histology, respectively. In the first-line therapy, 74, 42, and 2 cases were treated with sunitinib, sorafenib, and pazopanib, respectively. The median observation period was 23.4 months. Cases with CRP higher than 0,5mg/dl, Neu higher than the upper limit of normal (ULN), NLR higher than 2.5, Plt higher than ULN, anemia, and hypoalbuminemia had significantly worse OS than other cases (p<0.0001, p=0.0008, p<0.0001, p<0.0001, p=0.0094, and p<0.0001, respectively). Multivariate analysis revealed that pretreated CRP (hazard ratio (HR): 2.093, p=0.0179) and NLR (HR: 2.099, p=0.0431) were independent predictive factors of OS. In the higher CRP group and higher Neu group, the decreased CRP subgroup (1 year, 85.0%) and the decreased Neu subgroup (1 year, 73.9%) had significantly better OS than the non-decreased CRP subgroup (1-year, 37.2%, p<0.0001) and non-decreased Neu subgroup (1-year, 45.5%, p=0.0445). Multivariate analyses in the higher CRP group revealed that decrease of CRP was an independent predictive factor for OS (HR: 0.176, p=0.0008).

Conclusions: Decrease of CRP and pretreatment CRP can be novel predictive factors for OS in mRCC patients treated with molecular targeted therapy.

Source Of Funding: none

Jun Teishima

Hiroshima University

Education:
2002: Ph.D. (Dr. of Medical Science), Hiroshima University, Graduate school of Biomedical Sciences
(Thesis: Decreased expression of insulin-like growth factor binding protein related protein 1 in radiation-induced mouse hepatoma.)
1994: Graduated from Hiroshima University School of Medicine
1988: Graduated from High School


Professional Training and Employment
2015: Associate Professor, Department of Urology, Integrated Health Sciences,
Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima
2012: Lecturer, Department of Urology, Integrated Health Sciences,
Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima
2010: Lecturer, Department of Urology, Graduate School of Biochemical Sciences,
Hiroshima University, Hiroshima
2007-2008: Visiting Scholar, Center for Cancer and Stem Cell Biology,
Institute of Biosciences & Technology, Texas A&M Health Science Center,
Houston, TX
2004-2009: Assistant Professor, Department of Urology, Graduate School of Biochemical Sciences, Hiroshima University
2002-2004: Medical Staff in Urology, Kobatake Hospital, Fukuyama
1995-1999: Medical Staff in Urology, Shimane Prefectural Central Hospital, Izumo
1994-1995: Resident in Urology, Hiroshima University
1994: Passed the Examination of National Board

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MP16-10: The impact of kinetics of biomarkers on the prediction of overall survival in patients with metastatic renal cell carcinoma treated with a tyrosine kinase inhibitor.



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