Feasibility of the ACL (albumin, C-reactive protein and lactate dehydrogenase) model as a novel prognostic tool in patients with metastatic renal cell carcinoma previously receiving first-line targeted therapy

Tamura, Keita; Matsushita, Yuto; Watanabe, Haruo; Motoyama, Daisuke; Ito, Toshiki; Sugiyama, Tetsuya; Otsuka, Atsushi

doi:10.1016/j.urolonc.2019.07.013

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…Separately, a retrospective analysis suggested that CRP elevation was predictive of poor outcomes when incorporated into the International Metastatic Renal-Cell Carcinoma Database Consortium (IMDC) model for patients receiving axitinib. Additionally, several novel models incorporating CRP have been developed which show superiority to existing models (19,34,35). Of these, recently developed models assessing albumin, CRP, and lactate dehydrogenase (ACL model) or albumin, CRP, and neutrophil-lymphocyte-ratio (ACN model) were both found to have superior predictive value over both the IMDC and Memorial Sloan Kettering Cancer Center models.…”

Section: Crp In Renal Cell Carcinomamentioning

confidence: 99%

The Role of C-Reactive Protein in Kidney, Bladder, and Prostate Cancers

et al. 2021

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C-Reactive Protein (CRP) is associated with diverse outcomes in patients with, or suspected to have, genitourinary malignancies. CRP levels have been shown to be associated with the probability of a prostate cancer diagnosis in patients with elevated PSA, the probability of biochemical recurrence following definitive treatment for localized prostate cancer, and decreased overall survival for patients with advanced disease. In patients with bladder and kidney cancers, CRP levels have been associated with disease progression, stage, and cancer-specific survival. Despite the abundance of correlative studies, the relationship between CRP levels and genitourinary cancer pathogenesis is not clearly understood. Here, we review the evidence for CRP as a biomarker in genitourinary (GU) cancers, with specific focus on potential clinical applications.

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Section: Crp In Renal Cell Carcinomamentioning

confidence: 99%

The Role of C-Reactive Protein in Kidney, Bladder, and Prostate Cancers

et al. 2021

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“…Third, a focus was placed on only previously treated patients with mRCC receiving nivolumab; however, considering the current therapeutic trend for mRCC (4-6), prognostication of patients with treatment-naïve mRCC should also be investigated. Fourth, although the unbalanced distribution of patients with mRCC based on the MSKCC and IMDC models is considered a disadvantage (24), the proportion of patients classified into the intermediate risk group by the model used in the present study was the highest amongst the groups. Lastly, there may be other parameters that have not been well characterized, but are closely associated with the prognosis of patients with mRCC receiving ICIs that were not taken into consideration.…”

Section: Univariate Analysismentioning

confidence: 76%

Assessment of prognostic factors in previously treated Japanese patients with metastatic renal cell carcinoma who received nivolumab: An observational multi‑institute study

et al. 2021

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“…In previous studies, several prognostic markers for axitinib treatment have been suggested, such as NLR 25 , serum albumin level 26 , serum lactate dehydrogenase level 26 , and serum CRP level 27 , among others. However, the model-development cohorts for these studies consisted of heterogeneous populations that included patients who had received a variety of treatments, including several VEGFR-TKIs.…”

Section: Discussionmentioning

confidence: 99%

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

Numakura

Kobayashi

Muto

et al. 2020

Sci Rep

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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 χ2 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.

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Feasibility of the ACL (albumin, C-reactive protein and lactate dehydrogenase) model as a novel prognostic tool in patients with metastatic renal cell carcinoma previously receiving first-line targeted therapy

Cited by 9 publications

References 24 publications

The Role of C-Reactive Protein in Kidney, Bladder, and Prostate Cancers

The Role of C-Reactive Protein in Kidney, Bladder, and Prostate Cancers

Assessment of prognostic factors in previously treated Japanese patients with metastatic renal cell carcinoma who received nivolumab: An observational multi‑institute study

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

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