Impact of C-Reactive Protein Kinetics on Survival of Patients with Metastatic Renal Cell Carcinoma

Saito, Kazutaka; Tatokoro, Manabu; Fujii, Yasuhisa; Iimura, Yasumasa; Koga, Fumitaka; Kawakami, Satoru; Kihara, Kazunori

doi:10.1016/j.eururo.2008.10.012

Cited by 108 publications

(89 citation statements)

References 29 publications

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“…14 We provided evidence supporting the use of CRP kinetics as a dynamic marker of survival in patients with metastatic RCC. 56 Patients treated with multimodal therapy, including nephrectomy, metastasectomy and cytokine therapy, were grouped according to CRP kinetics with baseline and nadir CRP levels (cut-off point: 5 mg/L) as non-elevated , normalized and nonnormalized CRP groups. CRP kinetics predicted OS, improving the predictive accuracy by 4% to baseline CRP alone.…”

Section: Crp Kinetics In Renal Cell Carcinomamentioning

confidence: 99%

“…73 In the study, 80 patients receiving cisplatin-based systemic chemotherapy as a second-line setting were divided into three groups (non-elevated , normalized and non-normalized CRP group) according to their baseline and nadir CRP levels, using a cut-off value of 5 mg/L as in our previous report on RCC. 56 CRP kinetics status had a significant impact on survival with 1-year OS rates of 72, 51 and 14%, and median survival periods of 23, 13 and 6 months for non-elevated , normalized and non-normalized CRP groups, respectively. Furthermore, normalized CRP periods were also significantly associated with OS periods in those patients.…”

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confidence: 99%

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Role of C‐reactive protein in urological cancers: A useful biomarker for predicting outcomes

Saito

Kihara

2012

Int J of Urology

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Abbreviations & AcronymsAbstract: Based on increasing evidence of the association between cancer-related inflammation and the progression of cancer, the external symptoms of systemic inflammatory response has been shown to be an indicator for the prognosis of many malignancies, including urological cancers. C-reactive protein, a representative acute-phase reactant, is a significant and sensitive inflammatory marker that can be objectively measured using reliable assays in clinical practice worldwide. C-reactive protein has been shown to be significant in the prediction of outcomes of urological cancers. The elevation of C-reactive protein levels, which indicate the presence of cancer-associated systemic inflammatory response, is linked to poorer survival in patients with urological cancers, including renal cell carcinoma, upper urinary tract and bladder cancers, and prostate cancer. With this strong prognostic ability, C-reactive protein can be incorporated into prognostic models and will make them simpler and improve their predictive accuracy. Furthermore, the longitudinal change of C-reactive protein level, C-reactive protein kinetics, provides additional information on patient survival outcomes. As such, C-reactive protein can be used to monitor treatment efficacy and disease course using serial measurements. In testicular cancer, C-reactive protein is associated with a risk of late complications, such as cardiovascular disease, and with the development of second non-germ-cell cancer. Taken together, these findings show that C-reactive protein can act as an important biomarker for urological cancers. This review discusses the importance of C-reactive protein as a prognostic biomarker in urological cancers on the basis of the currently available evidence.

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Section: Crp Kinetics In Renal Cell Carcinomamentioning

confidence: 99%

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confidence: 99%

Role of C‐reactive protein in urological cancers: A useful biomarker for predicting outcomes

Saito

Kihara

2012

Int J of Urology

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“…Various biomarkers of inflammation, such as C-reactive protein (CRP) kinetics [5], CRP/ albumin ratio [6], platelet count [7], and the NLR have been reported as significant prognostic factors of RCC.Since these biomarkers are easily obtained from the patient's peripheral blood and are noninvasive and low cost, they are useful in terms of being less of a burden on patients. In 2001, Zahorec first reported that the NLR is a parameter that indicates the inflammation and stress of the entire body under critical conditions, and it can be assessed quickly and easily [8].…”

Section: Discussionmentioning

confidence: 99%

The Neutrophil-to-Lymphocyte Ratio as A Prognostic Factor For Long-Term Interleukin-2 Use in Renal Cell Carcinoma

Nagai¹,

Okamura²,

Tanaka³

et al. 2017

Immunome Res

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The neutrophil-to-lymphocyte ratio (NLR), a measure of systemic inflammation, has been reported to be a predictive parameter of patient prognosis. We speculated that the NLR is decreased in renal cell carcinoma (RCC) patients in whom interleukin (IL)-2 is effective. In this study, we retrospectively examined the usefulness of the NLR as a prognostic factor using three cases of RCC treated with long-term IL-2. In all three cases, the NLR remained less than 2.7 during IL-2 treatment, suggesting its effectiveness as a marker. During interferon-α or molecular targeted drug therapy, the NLR was unstable, regardless of treatment effectiveness, but a sudden rise in the NLR tended to suggest massive radiographic progression and worse prognosis. The results suggested that the NLR might serve as a useful marker for therapies when determining prognosis.

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“…However, the prognostic role of CRP kinetics after sunitinib initiation has not been investigated to date. Previous studies have demonstrated that postoperative normalization of the CRP level is associated with better prognosis in patients with localized or advanced RCC who receive nephrectomy, metastasectomy, or both (13)(14)(15)(16). In addition, CRP kinetics has been found to be a prognostic factor for the effect of cytokine therapies (13,15,17).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have demonstrated that postoperative normalization of the CRP level is associated with better prognosis in patients with localized or advanced RCC who receive nephrectomy, metastasectomy, or both (13-16). In addition, CRP kinetics has been found to be a prognostic factor for the effect of cytokine therapies (13,15,17). We hypothesized that CRP kinetics may be an important predictor of the efficacy of sunitinib treatment in patients with advanced RCC.…”

Section: Introductionmentioning

confidence: 99%

Prognostic effect of serum C-reactive protein kinetics on advanced renal cell carcinoma treated with sunitinib

Fujita

Tabata

Ishii

et al. 2017

Molecular and Clinical Oncology

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Abstract. C-reactive protein (CRP) is an independent prognostic factor for renal cell carcinoma (RCC). The aim of the present study was to investigate the prognostic effect of pretreatment serum CRP level and CRP kinetics on patients with advanced RCC treated with sunitinib. A total of 56 consecutive patients with advanced RCC treated with sunitinib between December, 2008 and December, 2012 were enrolled in the present study. The patients were retrospectively divided into 3 cohorts according to pretreatment serum CRP level and CRP kinetics: i) Normal CRP cohort (pretreatment CRP ≤0.30 mg/dl); ii) normalized CRP cohort (pretreatment CRP >0.30 mg/dl that normalized within 2 cycles of treatment); and iii) non-normalized CRP cohort (pretreatment CRP >0.30 mg/dl that did not normalize after sunitinib initiation). Disease control rate, progression-free survival and overall survival times were compared for the 3 cohorts. The normal (n=17, 30.4%) and the normalized (n=8, 14.3%) CRP cohorts exhibited significantly better disease control rates compared with the non-normalized CRP cohort (n=31, 55.4%; P<0.0001 and P=0.0445, respectively). The normal CRP cohort exhibited significantly longer progression-free survival compared with the non-normalized CRP cohort (P=0.0050). The normal and normalized CRP cohorts exhibited significantly longer overall survival compared with the non-normalized CRP cohort (P=0.0005 and 0.0466, respectively). Therefore, CRP kinetics and normal pretreatment CRP level are prognostic indicators in patients with advanced RCC treated with sunitinib. IntroductionC-reactive protein (CRP), which was found to be a representative acute-phase reactant in 1930, is the most widely used marker of systemic inflammation (1). Inflammation plays an important role during almost all stages of tumor development (2). For example, the proliferation of renal cell carcinoma (RCC) is associated with increased levels of interleukin-6 (IL-6), nuclear factor-κB, and other inflammatory factors (3,4), and the serum CRP levels were found to be correlated with the levels of proinflammatory cytokines, such as IL-6 (5). Numerous studies have demonstrated that CRP is a significant prognostic factor among patients with RCC at various stages, whether they are being treated by surgery, systemic therapy, or both (6).Sunitinib malate (Sutent, Pfizer Inc., New York, NY, USA) is an orally administered, small-molecule, multitargeted inhibitor of tyrosine kinases (e.g., vascular endothelial growth factor receptor, platelet-derived growth factor receptor, phosphorylation of stem cell factor receptor, Fms-like tyrosine kinase-3, colony-stimulating factor-1 receptor, and RET receptor tyrosine kinases). In a phase III clinical trial including patients with advanced RCC, sunitinib achieved significantly better results compared with interferon (IFN)-α and is approved worldwide for the treatment of advanced RCC (7,8). The number of patients treated with sunitinib is increasing and, therefore, there is an urgent need to identify biomarkers that may...

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Impact of C-Reactive Protein Kinetics on Survival of Patients with Metastatic Renal Cell Carcinoma

Cited by 108 publications

References 29 publications

Role of C‐reactive protein in urological cancers: A useful biomarker for predicting outcomes

Role of C‐reactive protein in urological cancers: A useful biomarker for predicting outcomes

The Neutrophil-to-Lymphocyte Ratio as A Prognostic Factor For Long-Term Interleukin-2 Use in Renal Cell Carcinoma

Prognostic effect of serum C-reactive protein kinetics on advanced renal cell carcinoma treated with sunitinib

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