Impact of Disagreement Between Two Risk Group Models on Prognosis in Patients With Metastatic Renal-Cell Carcinoma

Okita, Kazutaka; Tanaka, Toshiaki; Ikehata, Yoshinori; Tanaka, Toshikazu; Fujita, Naoki; Ishibashi, Yutaka; Yamamoto, Hayato; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Yoshikawa, Kunio; Kawaguchi, Toshiaki; Masumori, Naoya; Kitamura, Hiroshi; Οhyama, Chikara

doi:10.1016/j.clgc.2019.01.006

Cited by 19 publications

(21 citation statements)

References 32 publications

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“…Indeed they performed fairly accurate in predicting OS in different cohorts of mRCC patients undergoing first-and second-line targeted therapy (Heng et al, 2009;Ko et al, 2015;Tanaka et al, 2016). Their respective prognoses for around 23% of patients in a treatment-naïve cohort undergoing the first line of targeted therapy do not match, suggesting limited prognostic capacity (Okita et al, 2019). They also do not perform well in predicting OS in patients undergoing cytoreductive nephrectomy (Westerman et al, 2020).…”

Section: Comparison To Current Standardsmentioning

confidence: 99%

Circulating Non-coding RNAs in Renal Cell Carcinoma—Pathogenesis and Potential Implications as Clinical Biomarkers

Barth

Drula

Ott

et al. 2020

Front. Cell Dev. Biol.

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Liquid biopsy-the determination of circulating cells, proteins, DNA or RNA from biofluids through a "less invasive" approach-has emerged as a novel approach in all cancer entities. Circulating non-(protein) coding RNAs including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and YRNAs can be passively released by tissue or cell damage or actively secreted as cell-free circulating RNAs, bound to lipoproteins or carried by exosomes. In renal cell carcinoma (RCC), a growing body of evidence suggests circulating non-coding RNAs (ncRNAs) such as miRNAs, lncRNAs, and YRNAs as promising and easily accessible blood-based biomarkers for the early diagnosis of RCC as well as for the prediction of prognosis and treatment response. In addition, circulating ncRNAs could also play a role in RCC pathogenesis and progression. This review gives an overview over the current study landscape of circulating ncRNAs and their involvement in RCC pathogenesis as well as their potential utility as future biomarkers in RCC diagnosis and treatment.

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Section: Comparison To Current Standardsmentioning

confidence: 99%

Circulating Non-coding RNAs in Renal Cell Carcinoma—Pathogenesis and Potential Implications as Clinical Biomarkers

Barth

Drula

Ott

et al. 2020

Front. Cell Dev. Biol.

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Objectives To evaluate the effect of pretreatment C‐reactive protein/albumin ratio and modified Glasgow prognostic score on the prognosis in patients with metastatic renal cell carcinoma. Methods A retrospective study was carried out in 176 patients with metastatic renal cell carcinoma who received first‐line tyrosine kinase inhibitors. The effect of adding inflammatory prognostic scores to the International Metastatic Renal Cell Carcinoma Database Consortium model (International Metastatic Renal Cell Carcinoma Database Consortium‐C‐reactive protein/albumin ratio and International Metastatic Renal Cell Carcinoma Database Consortium‐Glasgow prognostic score models) on overall survival was evaluated using receiver operating characteristic curves. The prognostic value of inflammatory prognostic scores (C‐reactive protein/albumin ratio‐modified Glasgow prognostic score) was tested using the Kaplan–Meier method and Cox proportional regression models. Results Patients were stratified into two groups using the cut‐off value of 0.05: C‐reactive protein/albumin ratio‐low (<0.05) and C‐reactive protein/albumin ratio‐high (≥0.05). The area under the curve was significantly higher in the International Metastatic Renal Cell Carcinoma Database Consortium‐C‐reactive protein/albumin ratio model (0.720) than that of the International Metastatic Renal Cell Carcinoma Database Consortium model (0.689) and the International Metastatic Renal Cell Carcinoma Database Consortium‐modified Glasgow prognostic score model (0.703). Significant differences were observed in overall survival stratified by the number of risk factors in the International Metastatic Renal Cell Carcinoma Database Consortium‐C‐reactive protein/albumin ratio risk model between one or two and three or four factors (P < 0.001), and three or four and five or more factors (P = 0.001). For the patients in the International Metastatic Renal Cell Carcinoma Database Consortium intermediate‐risk group, overall survival was significantly different between the C‐reactive protein/albumin ratio‐low and ‐high groups (P = 0.001), whereas it was not significantly different between the patients with one and two International Metastatic Renal Cell Carcinoma Database Consortium risk factors (P = 0.106). Conclusion The C‐reactive protein/albumin ratio is a simple and independent predictor of overall survival in patients with metastatic renal cell carcinoma. The predictive activity was significantly improved in the International Metastatic Renal Cell Carcinoma Database Consortium‐C‐reactive protein/albumin ratio model compared with the International Metastatic Renal Cell Carcinoma Database Consortium/International Metastatic Renal Cell Carcinoma Database Consortium‐modified Glasgow prognostic score models.

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“…Little research has been conducted on the agreement in risk-group classification between the MSKCC and IMDC classification systems. Recently, Okita et al 6 patients having IMDC poor-risk disease is 25-30% according to Okita et al 6 The results of CARMENA are not applicable to the IMDC classification owing to the differences between the classification systems, but patients with IMDC poor-risk disease are unlikely to benefit from surgery. 8 Currently, recommended systemic first-line treatments for mRCC are sunitinib, pazopanib, cabozantinib, or nivolumab plus ipilimumab.…”

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confidence: 99%

“…However, importantly, nearly 50% of patients with IMDC poor-risk disease could be reclassified to the MSKCC intermediate-risk group, whereas 50% would remain in the MSKCC poor-risk group according to the results of Okita and colleagues. 6 Evidence is insufficient to support use of sunitinib in patients with MSKCC poor-risk disease and, therefore, it might not be an alternative option for these patients if nivolumab plus ipilimumab is not feasible or safe.…”

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confidence: 99%

“…This involved a change from MSKCC intermediate-riskto IMDC-poor-risk disease or vice versa in >80% of reclassified patients, and the majority of changes were related to the neutrophil count. Disagreement was associated with reduced progression-free survival (HR 1.9, P = 0.025) and overall survival (HR=1.75, P = 0.028) 6. Thus, disagreement is common, prognostically relevant and has the potential to influence management.The CARMENA trial 7 (NCT00930033) showed that sunitinib alone is not inferior toimmediate cytoreductive nephrectomy followed by sunitinib in patients with synchronous metastatic clear-cell RCC.…”

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confidence: 99%

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Disagreement in risk groups for metastatic renal cancer

Klatte

Stewart

2019

Nat Rev Urol

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In patients with metastatic renal cell carcinoma, risk stratification according to the Memorial Sloan-Kettering Cancer Center or the International Metastatic Renal Cell Carcinoma Database Consortium classification systems is a crucial part of clinical assessment and essential for guiding management. New research has now demonstrated that disagreement in risk-group classification is common and prognostically relevant.

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Impact of Disagreement Between Two Risk Group Models on Prognosis in Patients With Metastatic Renal-Cell Carcinoma

Cited by 19 publications

References 32 publications

Circulating Non-coding RNAs in Renal Cell Carcinoma—Pathogenesis and Potential Implications as Clinical Biomarkers

Circulating Non-coding RNAs in Renal Cell Carcinoma—Pathogenesis and Potential Implications as Clinical Biomarkers

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

Disagreement in risk groups for metastatic renal cancer

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