Current status of prognostic factors in patients with metastatic renal cell carcinoma

Abstract

In recent years, the induction of novel agents, including molecular‐targeted agents and immune checkpoint inhibitors, have dramatically changed therapeutic options and their outcomes for metastatic renal cell carcinoma. Several prognostic models based on the data of patients with metastatic renal cell carcinoma treated with targeted agents or cytokine therapy have been useful in real clinical practice. Serum or peripheral blood markers related to inflammatory response have been reported to be associated with their prognosis or therapeutic efficacy. In addition to them, investigation for novel predictive factors that represent the efficacy of agents, the risk of adverse events and the prognosis are required for the advance of therapeutic strategies. The present review discusses the conventional prognostic models and clinical factors, and recent advances of the identification of some of the most promising molecules as novel biomarkers for metastatic renal cell carcinoma.

Twenty-year survival after iterative surgery for metastatic renal cell carcinoma: A case report and review of literature

“…Well-established prognostic factors for localized RCC include the size of the primary tumour; the extent of disease spread; the tumour histology; the presence of microvascular invasion and of collective system invasion; a high tumour grade and the presence of necrosis at histology; several clinical factors such as male sex, advanced age, poor performance status (PS), and symptomatic presentation[ 7 , 27 ]. Similarly, multiple pathological and clinical variables have prognostic relevance in mRCC patients proposed for the available systemic therapies[ 27 , 28 ]; these include the tumour histology; the number, size and site of metastases[ 28 ], with liver and bone metastases having the worst prognosis[ 29 , 30 ]; the tumour shrinkage after treatment with targeted agents[ 28 ]. Various integrated scoring systems that aim to optimize prognostication and treatment strategies are based on some of these prognostic factors, comprehending the Memorial Sloan Kettering Cancer Center (MSKCC) and the IMDC prognostic scores[ 4 , 7 , 27 , 28 ].…”

C‐reactive protein/albumin ratio is a predictive factor for prognosis in patients with metastatic renal cell carcinoma

“…In recent decades, molecular-targeted therapies have been generally used for treatment of mRCC. [1][2][3][4][5][6][7][8][9][10][11] As prognoses in mRCC have improved, more precise stratifications based on risk factors have been required. In the molecular-targeted therapy era, the IMDC risk classification is a standard riskbased stratification.…”

“…In recent decades, molecular‐targeted therapies have been generally used for treatment of mRCC . As prognoses in mRCC have improved, more precise stratifications based on risk factors have been required.…”

Improved prognosis for elderly patients with metastatic renal cell carcinoma in the era of targeted therapy

“…It is thus expected that the continuing increase of therapeutic options (including ICIs as well as targeted agents) will lead to further improvement in the prognosis for patients with mRCC in the coming years. At the same time, we expect that a more personalized therapeutic strategy will be established for older patients that is based on key molecules identified through gene sequencing in addition to conventional predictive factors for prognosis and agent efficacy (22,23) as older patients tend to have more comorbidities than younger ones.…”