Prognostic impact of pretreatment C-reactive protein for patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors

Yasuda, Yosuke; Saito, Kazutaka; Yuasa, Takeshi; Kitsukawa, Shinichi; Urakami, Shinji; Yamamoto, Shinya; Yonese, Junji; Takahashi, Shunji; Fukui, Iwao

doi:10.1007/s10147-012-0454-0

Cited by 40 publications

(33 citation statements)

References 24 publications

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“…Jabs WJ et al showed that activity of the IL-6/CRP network in RCC patients contributes to the acute-phase reaction in local inflammatory processes [29]. Other clinical data also showed that elevated CRP level is associated with poorer OS of RCC patients [30, 31] and CRP has a significant impact on OS of metastatic RCC patients treated with a tyrosine kinase inhibitor, either sunitinib or sorafenib [32, 33]. …”

Section: Discussionmentioning

confidence: 99%

The C-reactive protein/albumin ratio, a validated prognostic score, predicts outcome of surgical renal cell carcinoma patients

Guo

Chen

et al. 2017

BMC Cancer

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BackgroundThe preoperative C-reactive protein/Albumin (CRP/Alb) ratio has been shown to be valuable in predicting the prognosis of patients with certain cancers. The aim of our study is to explore its prognostic value in patients with renal cell carcinoma (RCC).MethodsA retrospective study was performed in 570 RCC patients underwent radical or partial nephrectomy including 541 patients who received full resection of localized (T1-3 N0/+ M0) RCC. The optimal cutoff value of CRP/Alb was determined by the receive operating characteristic (ROC) analysis. The impact of the CRP/Alb and other clinicopathological characteristics on overall survival (OS) and disease-free survival (DFS) was evaluated using the univariate and multivariate Cox regression analysis.ResultsThe optimal cutoff of CRP/Alb ratio was set at 0.08 according to the ROC analysis. Multivariate analysis indicated that CRP/Alb ratio was independently associated with OS of RCC patients underwent radical or partial nephrectomy (hazard ratio [HR]: 1.94; 95% confidence interval [95% CI]: 1.12–3.36; P = 0.018), and DFS of localized RCC patients underwent full resection (HR: 2.14; 95% CI: 1.22–3.75; P = 0.008).ConclusionElevated CRP/Alb ratio was an independent prognostic indicator for poor OS in patients underwent radical or partial nephrectomy and DFS of localized RCC patients underwent full resection. Overall, CRP/Alb may help to identify patients with high relapse risk.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3119-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The C-reactive protein/albumin ratio, a validated prognostic score, predicts outcome of surgical renal cell carcinoma patients

Guo

Chen

et al. 2017

BMC Cancer

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“…CRP has been shown to be a non-specific biomarker in patients with various stages of RCC who receive surgery (13-16,18-21), immunotherapy (13,15,17,22,23) and molecular-targeted therapy (9)(10)(11)(12). CRP has a promising role in predicting survival among patients with localized and metastatic RCC.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have revealed a prognostic role for CRP in the outcome of sunitinib treatment (9)(10)(11)(12). Normal pretreatment CRP levels predict a higher response rate and better survival among patients undergoing sunitinib treatment (9,11).…”

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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“…A total of 43 eligible studies (7, 490 patients) were identified for this meta-analysis (25 for RCC (Atzpodien et al, 2003;Bromwich et al, 2004;Casamassima et al, 2005;Peccatori et al, 2005;Ito et al, 2006;Lamb et al, 2006;Vogl et al, 2006;Karakiewicz et al, 2007;Komai et al, 2007;Ramsey et al, 2007;Kawata et al, 2008;Ramsey et al, 2008;Tanaka et al, 2008;Iimura et al, 2009;Jagdev et al, 2010;Cho et al, 2011;Falkensammer et al, 2011;Bedke et al, 2012;Fujita et al, 2012;Sim et al, 2012;Steffens et al, 2012;de Martino et al, 2013;Yasuda et al, 2013), 10 for UC (Hilmy et al, 2005;Hilmy et al, 2006;Saito et al, 2007;Yoshida et al, 2008;Gakis et al, 2011;Saito and Kihara, 2011;Ishioka et al, 2012;Obata et al, 2012;Tanaka et al, 2012;Stein et al, 2013), and 8 for PC (McArdle et al, 2006;Beer et al, 2008;Nakashima et al, 2008;McArdle et al, 2010;Pond et al, 2012;Prins et al, ...…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Prognostic Significance of C-reactive Protein in Urological Cancers: a Systematic Review and Meta-analysis

Dai¹,

Tang²,

Wei³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Prognostic impact of pretreatment C-reactive protein for patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors

Abstract: CRP has a significant impact on overall survival of patients with metastatic renal cell carcinoma carcinoma treated with tyrosine kinase inhibitors.

Cited by 40 publications

References 24 publications

The C-reactive protein/albumin ratio, a validated prognostic score, predicts outcome of surgical renal cell carcinoma patients

The C-reactive protein/albumin ratio, a validated prognostic score, predicts outcome of surgical renal cell carcinoma patients

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

Prognostic Significance of C-reactive Protein in Urological Cancers: a Systematic Review and Meta-analysis

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