scholarly journals Volumetric body composition parameters in predicting survival outcomes of metastatic renal cell carcinoma patients treated with targeted therapy

2021 ◽  
Author(s):  
Oktay Aktepe ◽  
Ahmet Gürkan Erdemir ◽  
Gurkan Guner ◽  
Deniz Can Güven ◽  
Suayib Yalcin ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Renal Cell Carcinoma ◽  
Body Composition ◽  
Adipose Tissue ◽  
Targeted Therapy ◽  
Cell Carcinoma ◽  
Risk Score ◽  
Renal Cell ◽  
Survival Outcomes ◽  
Skeletal Muscle Index

Background: To explore the clinical significance of baseline volumetric body composition parameters evaluated with computerized tomography (CT) and their changes after 3-4 months from treatment initiation of targeted therapy in patients with metastatic renal cell carcinoma (mRCC). Method: This study included 108 Caucasian mRCC patients (Male/Female: 77/31) treated with targeted therapy. Volumetric body composition parameters including total adipose tissue index (TATI), subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI) and skeletal muscle index (SMI) values were depicted from CT images at third lumbar vertebra level through volumetric measurement software. Kaplan-Meier method and the long test were used for estimation of progression free survival (PFS) and overall survival (OS). Univariate and multivariate analyses were done to determine the associations between clinic-pathologic variables including VBC and survival outcomes. Results: The median PFS and OS of all patients were 11 months and 46 months in patients respectively. After adjustment for the variables including international mRCC database consortium (IMDC) risk score, only a high skeletal muscle index (SMI) was associated with better PFS (HR: 0.975, P=0.015). The independent predictors for OS were VATI (HR 1.005, P=0.024), SATI (HR: 0.976, P=0.019) and TATI (HR: 0.982, P=0.035) in addition to IMDC risk score. Conclusion: Our findings revealed that while SMI was the only significant determinant parameter for PFS among VBC parameters, TATI, VATI, and SATI were determined as independent predictors for OS in addition to IMDC risk score.

Skeletal muscle density as a positive predictive factor for nivolumab therapy in patients with metastatic renal cell carcinoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17107-e17107
Author(s):  
Meltem Ekenel ◽  
Murat Sari ◽  
Samil Aliyev ◽  
Mert Basaran
Keyword(s):  
Skeletal Muscle ◽  
Renal Cell Carcinoma ◽  
Adipose Tissue ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Predictive Factor ◽  
Renal Cell ◽  
Intermediate Risk ◽  
Second Line ◽  
Muscle Density

e17107 Background: Immunotherapy has shown promising clinical responses in patients with metastatic Renal Cell Carcinoma (mRCC) at second-line therapy. Since objective response rates are highly variable, it is utmost important to identify patients who may benefit from immunotherapy to avoid unnecessary adverse effects and costs. Therefore, predictive as well as prognostic markers need to be studied extensively. To our knowledge, none of the body composition measurements such as fat content or skeletal muscle density have been assessed for this purpose. The objective of the current study is to analyze whether skeletal muscle (either muscle mass or muscle density) and adipose tissue play a prognostic role in patients with mRCC who were treated with immunotherapy at second line. Methods: We retrospectively analyzed 14 patients with mRCC who were progressed after tyrosine kinase inhibitor therapy and treated with Nivolumab between March 2016 and September 2019. Skeletal muscle density (SMD), skeletal muscle and adipose tissue were assessed with computed tomography imaging. Overall Survival (OS) and Progression Free Survival (PFS) were estimated by using the Kaplan-Meier method. Results: The median OS was 13,1 months and it was strongly associated with SMD; the median OS was significantly longer in patients with high SMD compared to patients with low SMD (6,9 months vs 18,5 months; P < 0,05). Also in our analysis, SMD separated the intermediate-risk group into 2 groups with different median OS periods, ranging from 8,1 months (95% confidence interval [95% CI], 5,1 months-11,1 months) in patients with intermediate-risk Heng score and low SMD to 21,5 months (95% CI, 14 months-27 months) in patients with an intermediate-risk Heng score and high SMD. Other parameters calculated for adipose tissue or skeletal muscle did not cause any significant change in survival analysis. Conclusions: High SMD appears to be associated with improved outcome in our small patient population. It could be a predictive factor when immunotherapy, Nivolumab, is considered for therapy of mRCC patients at second line.

scholarly journals Survival outcomes of double- and triple-sequential targeted therapy in patients with metastatic renal cell carcinoma: a retrospective comparison

Oncotarget ◽  
2017 ◽  
Vol 8 (59) ◽  
pp. 100056-100065 ◽  
Author(s):  
Sung Han Kim ◽  
Yoon Seok Suh ◽  
Jung Kwon Kim ◽  
Jae Young Joung ◽  
Ho Kyung Seo ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Targeted Therapy ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Survival Outcomes ◽  
Retrospective Comparison

Survival outcomes and practice trends for off-label use of adjuvant targeted therapy in high-risk locoregional renal cell carcinoma

2020 ◽  
Vol 38 (6) ◽  
pp. 604.e1-604.e7 ◽  
Author(s):  
Nicholas H. Chakiryan ◽  
Ann Martinez Acevedo ◽  
Mark A. Garzotto ◽  
Yiyi Chen ◽  
Jen-Jane Liu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Targeted Therapy ◽  
High Risk ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Survival Outcomes ◽  
Off Label Use ◽  
Off Label ◽  
Label Use

scholarly journals Visceral Adiposity as a Significant Predictor of Sunitinib-Induced Dose-Limiting Toxicities and Survival in Patients with Metastatic Clear Cell Renal Cell Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3602
Author(s):  
Jee Soo Park ◽  
Kyo Chul Koo ◽  
Doo Yong Chung ◽  
Sun Il Kim ◽  
Jeongho Kim ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Body Composition ◽  
Adipose Tissue ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Visceral Adiposity ◽  
Cell Renal Cell Carcinoma

Sunitinib is a first-line treatment for metastatic renal cell carcinoma (mRCC). Little is known about the predictive factors of sunitinib-induced dose-limiting toxicity (DLT) in Asian populations. We investigated whether body composition predicts sunitinib-induced DLT. We retrospectively reviewed sunitinib-treated Korean patients with clear cell mRCC from eight institutions. Body composition was measured using computed tomography. DLT was defined as any adverse event leading to dose reduction or treatment discontinuation. Univariate analysis was used to compare body composition indices, and logistic regression analyses were performed for factors predicting early DLT. Overall, 111/311 (32.5%) of patients experienced DLT. Significant differences were observed in the subcutaneous adipose tissue index (SATI; p = 0.001) and visceral adipose tissue index (VATI; p < 0.001) between patients with and without DLT. Multivariate analyses revealed that VATI (odds ratio: 1.013; p = 0.029) was significantly associated with early DLT. Additionally, 20% of patients who had a body mass index (BMI) greater than 23 kg/m2 and a low VATI experienced DLT, whereas 34.3% of the remaining groups had DLT (p = 0.034). Significant differences were observed for median progression-free survival (13.0 vs. 26.0 months, respectively; p = 0.006) between patients with low and high VATI. Visceral adiposity was a significant predictor of sunitinib-associated DLT and survival. Patients with a low VATI and a BMI greater than 23 kg/m2 experienced lower DLTs.

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