Improvement of prognosis in patients with metastatic renal cell carcinoma and Memorial Sloan-Kettering Cancer Center intermediate risk features by modern strategy including molecular-targeted therapy in clinical practice

Abstract

The modern strategy including molecular-targeted therapy may improve OS in patients with mRCC and MSKCC intermediate risk features in clinical practice, relative to those with other risk features. However, the prognosis for patients with tumors of histological type other than clear-cell, decreased Hb, elevated LDH, elevated CRP, or metastases at ≥ 3 sites remains poor even in the modern molecular-targeted era. Novel treatment strategies are necessary to improve prognosis in these patients.

Prognostic Role of C-Reactive Protein In Urological Cancers: A Meta-Analysis

“…Most of these studies were conducted in Asia (n = 31), Europe (n = 11) and North America (n = 2). Of these studies, 6 explored the CRP in the prognosis of prostate cancer 14 15 16 17 18 19 , 27 of renal cell carcinoma 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 and 11 of urothelial carcinoma originating from bladder (n = 6) and upper urinary tract (n = 5) 47 48 49 50 51 52 53 54 55 56 57 . The number of patients ranged from 30 to 1161 among the studies.…”

“…The multivariable HR (95% CI) for CSS was 3.66 (fixed-effect model; [HR] = 3.66, 95% CI = 2.20–6.09; p < 0.01) ( Supplementary Figure S1A online). Another five studies included 585 cases and summarized that elevated pretreatment CRP was a poor predictor for OS in patients with metastatic RCC treated with molecular-targeted therapy 37 39 41 42 46 (random-effects model; [HR] = 1.86, 95% CI = 1.30–2.66; p < 0.01) ( Supplementary Figure S1B online). In addition, CRP also predicted a poor survival in metastatic prostate cancer no matter treated with chemotherapy 15 19 (OS: fixed-effect model; [HR] = 2.18, 95% CI = 1.55–3.07; p < 0.01) ( Supplementary Figure S1C online)or endocrine therapy 14 16 (CSS: fixed-effect model; [HR] = 1.92, 95% CI = 1.22–3.03; p < 0.01) ( Supplementary Figure S1D online).…”

Experience of the nivolumab use in patients with metastatic renal cell carcinoma provided under the expanded access program in Russia. Subgroup analysis of the correlation between expression markers and the effectiveness of nivolumab therapy

“…На данный момент в клинической практике продолжают использоваться 2 основные прогностические модели MSKCC и IMDC [7][8]. Обе модели отражают биологическое течении заболевания, а не его чувствительность к иммунотерапии.…”