The addition of neutrophil-to-lymphocyte ratio to Heng risk model discriminates better overall survival in patients with metastatic renal cell cancer

The aim of this study was to evaluate the association between axitinib, sunitinib and temsirolimus toxicities and patient survival in metastatic renal cell cancer patients. Overall survival (OS) and progression-free survival (PFS) of metastatic renal cell cancer patients from the prospective multicenter STAR-TOR study were assessed using multivariable Cox models. A total of 1195 patients were included (n = 149 axitinib; n = 546 sunitinib; n = 500 temsirolimus). The following toxicities significantly predicted outcomes: hand–foot skin reaction (hazard ratio [HR] = 0.29) for PFS with axitinib; stomatitis (HR = 0.62) and pneumonitis (HR = 0.23) for PFS with temsirolimus; stomatitis (HR = 0.52) and thrombocytopenia (HR = 0.6) for OS with temsirolimus; fatigue (HR = 0.71) for PFS with sunitinib; hand–foot skin reaction (HR = 0.56) and fatigue (HR = 0.58) for OS with sunitinib. In conclusion, in metastatic renal cell cancer, axitinib, sunitinib and temsirolimus demonstrate specific toxicities that are protective OS/PFS predictors.

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Overall survival after immunotherapy, tyrosine kinase inhibitors and surgery in treatment of metastatic renal cell cancer: outcome of 143 consecutive patients from a single centre

Scandinavian Journal of Urology ◽

10.3109/21681805.2013.876550 ◽

2014 ◽

Vol 48 (4) ◽

pp. 379-386 ◽

Cited By ~ 4

Author(s):

Trine Honnens De Lichtenberg ◽

Gregers G. Hermann ◽

Mikael Rørth ◽

Mari-Janne Højer Larsen ◽

Zahra Mansourvar ◽

...

Keyword(s):

Overall Survival ◽

Tyrosine Kinase ◽

Tyrosine Kinase Inhibitors ◽

Renal Cell Cancer ◽

Renal Cell ◽

Kinase Inhibitors ◽

Cell Cancer ◽

Single Centre ◽

Metastatic Renal Cell Cancer ◽

Cancer Outcome

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A population-based study evaluating the impact of sunitinib on overall survival in the treatment of patients with metastatic renal cell cancer

Cancer ◽

10.1002/cncr.24051 ◽

2009 ◽

Vol 115 (4) ◽

pp. 776-783 ◽

Cited By ~ 38

Author(s):

Daniel Y. C. Heng ◽

Kim N Chi ◽

Nevin Murray ◽

Tao Jin ◽

Jorge A Garcia ◽

...

Keyword(s):

Overall Survival ◽

Renal Cell Cancer ◽

Renal Cell ◽

Cell Cancer ◽

Population Based ◽

Population Based Study ◽

Metastatic Renal Cell Cancer ◽

The Impact

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Review of the Interaction Between Body Composition and Clinical Outcomes in Metastatic Renal Cell Cancer Treated with Targeted Therapies

Journal of Kidney Cancer and VHL ◽

10.15586/jkcvhl.2016.45 ◽

2016 ◽

Vol 3 (1) ◽

pp. 12-22 ◽

Cited By ~ 2

Author(s):

Steven M Yip ◽

Daniel Y. C. Heng ◽

Patricia A. Tang

Keyword(s):

Overall Survival ◽

Body Composition ◽

Targeted Therapy ◽

Clinical Outcomes ◽

Renal Cell Cancer ◽

Targeted Therapies ◽

Renal Cell ◽

Cell Cancer ◽

Metastatic Renal Cell Cancer ◽

The Impact

Treatment of metastatic renal cell cancer (mRCC) currently focuses on inhibition of the vascular endothelial growth factor pathway and the mammalian target of rapamycin (mTOR) pathway. Obesity confers a higher risk of RCC. However, the influence of obesity on clinical outcomes in mRCC in the era of targeted therapy is less clear. This review focuses on the impact of body composition on targeted therapy outcomes in mRCC. The International Metastatic Renal Cell Carcinoma Database Consortium database has the largest series of patients evaluating the impact of body mass index (BMI) on outcomes in mRCC patients treated with targeted therapy. Overall survival was significantly improved in overweight patients (BMI ? 25 kg/m2), and this observation was externally validated in patients who participated in Pfizer trials. In contrast, sarcopenia is consistently associated with increased toxicity to inhibitors of angiogenesis and mTOR. Strengthening patients with mRCC and sarcopenia, through a structured exercise program and dietary intervention, may improve outcomes in mRCC treated with targeted therapies. At the same time, the paradox of obesity being a risk factor for RCC while offering a better overall survival in response to targeted therapy needs to be further evaluated.

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