[Prognostic factors for metastatic renal cell carcinoma treated with second-line targeted therapies]. / Étude des facteurs pronostiques pour le carcinome rénal métastatique traité par une deuxième ligne de thérapies ciblées.
Prog Urol
; 26(1): 16-23, 2016 Jan.
Article
in Fr
| MEDLINE
| ID: mdl-26455779
ABSTRACT
OBJECTIVE:
To assess the prognostic value of clinical and biological features in patients treated with second-line targeted therapies (TT) for a metastatic renal cell carcinoma (mRCC). MATERIAL ANDMETHODS:
A retrospective study was performed including 60 patients treated with second-line TT from 2006 to 2013. Clinical and biological features were collected, including TT-induced toxicities, Heng and MSKCC prognostic scores, and renal function. Overall survival (OS) and progression-free survival (PFS) were assessed using univariate and multivariate analysis.RESULTS:
The median age was 61 years [39-81]. MSKCC and Heng scores were significantly prognostic for OS and PFS (P<0.05). Hypo-albuminemia, anemia and brain metastasis were associated with poorer OS and PFS (P<0.05). Severe induced toxicities had a prognostic impact with higher OS (26 months vs 10 months, P=0.003) and PFS (5 months vs 4 months, P=0.047). Renal function impairment at the initiation of the second line was also associated with higher survival (OS=24 months vs 9 months, P=0.035 and PFS=7 months vs 4 months, P=0.043). On multivariate analysis, induced toxicity was found as an independent factor of good prognosis for OS (HR=0.36; P=0.01).CONCLUSION:
Our results suggested that renal function impairment and TT-induced toxicities in the second line of treatment for mRCC have a potential prognostic interest as it had previously been reported for the first line of TT. LEVEL OF EVIDENCE 5.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Carcinoma, Renal Cell
/
Molecular Targeted Therapy
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Kidney Neoplasms
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Antineoplastic Agents
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
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Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Language:
Fr
Year:
2016
Type:
Article