Outcomes According to MSKCC Risk Score with Focus on the Intermediate-Risk Group in Metastatic Renal Cell Carcinoma Patients Treated with First-Line Sunitinib: A Retrospective Analysis of 2390 Patients
Abstract
:1. Background
2. Materials and Methods
2.1. Study Design and Treatment
2.2. Data Source
2.3. Outcome Assessment
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Treatment Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | MSKCC Risk Group | |||||
---|---|---|---|---|---|---|
Favourable | Intermediate | Poor | Intermediate | All Patients | ||
One Risk Factor | Two Risk Factors | |||||
n (%) | 806 (33.7) | 1450 (60.7) | 134 (5.6) | 969 (40.5) | 481 (20.1) | 2390 (100) |
Gender, n (%) | ||||||
Female | 225 (27.9) | 405 (27.9) | 37 (27.6) | 261 (26.9) | 144 (29.9) | 667 (27.9) |
Male | 581 (72.1) | 1045 (72.1) | 97 (72.4) | 708 (73.1) | 337 (70.1) | 1723 (72.1) |
Age at diagnosis (yr): median | 57.9 | 61.5 | 62.6 | 60.8 | 62.8 | 60.3 |
Histology, n (%) | ||||||
Clear cell carcinoma | 772 (95.8) | 1365 (94.1) | 125 (93.3) | 908 (93.7) | 457 (95.0) | 2262 (94.6) |
Papillary carcinoma | 30 (3.7) | 72 (5.0) | 7 (5.3) | 53 (5.5) | 19 (4.0) | 109 (4.5) |
Chromophobe carcinoma | 2 (0.3) | 6 (0.4) | 1 (0.8) | 5 (0.5) | 1 (0.2) | 9 (0.4) |
Bellini duct carcinoma | 1 (0.1) | 5 (0.3) | 0 (0) | 2 (0.2) | 3 (0.6) | 6 (0.3) |
Oncocytoma | 1 (0.1) | 1 (0.1) | 0 (0) | 1 (0.1) | 0 (0) | 2 (0.1) |
Unknown | 0 (0) | 1 (0.1) | 1 (0.7) | 0 (0) | 1 (0.2) | 2 (0.1) |
Stage at diagnosis, n (%) | ||||||
I | 209 (25.9) | 139 (9.6) | 1 (0.7) | 117 (12.1) | 22 (4.6) | 349 (14.6) |
II | 162 (20.1) | 144 (9.9) | 2 (1.5) | 119 (12.3) | 25 (5.2) | 308 (12.9) |
III | 180 (22.3) | 251 (17.3) | 15 (11.2) | 176 (18.2) | 75 (15.6) | 446 (18.7) |
IV | 110 (13.6) | 791 (54.6) | 112 (83.6) | 464 (47.9) | 327 (68.0) | 1013 (42.4) |
Unknown | 145 (18.0) | 125 (8.6) | 4 (3.0) | 93 (9.6) | 32 (6.7) | 274 (11.5) |
Primary tumour grade, n (%) | ||||||
G1 | 76 (9.4) | 98 (6.8) | 8 (6.0) | 69 (7.1) | 29 (6.0) | 182 (7.6) |
G2 | 342 (42.4) | 459 (31.7) | 45 (33.6) | 327 (33.7) | 132 (27.4) | 846 (35.4) |
G3–4 | 219 (27.2) | 646 (44.6) | 63 (47.0) | 397 (41.0) | 249 (51.8) | 928 (38.8) |
Unknown | 169 (21.0) | 247 (17.0) | 18 (13.4) | 176 (18.2) | 71 (14.8) | 434 (18.2) |
MSKCC Risk Factors | ||||||
ECOG PS 0–1, n (%) | 806 (100) | 1347 (92.9) | 94 (70.1) | 920 (94.9) | 427 (88.8) | 2247 (94.0) |
ECOG PS ≥ 2, n (%) | 0 (0) | 103 (7.1) | 40 (29.9) | 49 (5.1) | 54 (11.2) | 143 (6.0) |
Serum calcium ≤ 2.5 mmol/l, n (%) | 806 (100) | 1325 (91.4) | 71 (53.0) | 907 (93.6) | 418 (86.9) | 2202 (92.1) |
Serum calcium > 2.5 mmol/l, n (%) | 0 (0) | 125 (8.6) | 63 (47.0) | 62 (6.4) | 63 (13.1) | 188 (7.9) |
Haemoglobin normal, n (%) | 806 (100) | 887 (61.2) | 12 (9.0) | 747 (77.1) | 140 (29.1) | 1705 (71.3) |
Haemoglobin < LLN, n (%) | 0 (0) | 563 (38.8) | 122 (91.0) | 222 (22.9) | 341 (70.9) | 685 (28.7) |
Time from diagnosis to therapy initiation ≥ 1 year, n (%) | 806 (100) | 444 (30.6) | 11 (8.2) | 384 (39.6) | 60 (12.5) | 1261 (52.8) |
Time from diagnosis to therapy initiation < 1 year, n (%) | 0 (0) | 1006 (69.4) | 123 (91.8) | 585 (60.4) | 421 (87.5) | 1129 (47.2) |
LDH ≤ 1.5 time ULN, n (%) | 806 (100) | 1316 (90.8) | 56 (41.8) | 918 (94.7) | 398 (82.7) | 2178 (91.1) |
LDH > 1.5 time ULN, n (%) | 0 (0) | 134 (9.2) | 78 (58.2) | 51 (5.3) | 83 (17.3) | 212 (8.9) |
Outcomes | MSKCC Risk Group | |||||
---|---|---|---|---|---|---|
Favourable | Intermediate | Poor | Intermediate | All Patients | ||
One Risk Factor | Two Risk Factors | |||||
Objective Overall Response | ||||||
n | 806 | 1450 | 134 | 969 | 481 | 2390 |
Objective response rate (%) † | 33.0 | 24.1 | 13.4 | 26.7 | 18.7 | 26.5 |
p-value < 0.001 | p-value = 0.001 | |||||
Complete response (%) | 7.4 | 4.6 | 0.7 | 5.8 | 2.1 | 5.3 |
Partial response (%) | 25.6 | 19.5 | 12.7 | 20.9 | 16.6 | 21.2 |
Stable disease (%) | 35.1 | 32.9 | 18.7 | 33.7 | 31.2 | 32.8 |
Progressive disease (%) | 15.9 | 24.0 | 39.6 | 22.7 | 26.6 | 22.1 |
Not evaluable (%) | 16.0 | 19.0 | 28.4 | 16.8 | 23.5 | 18.5 |
Overall Survival (OS) | ||||||
n | 806 | 1450 | 134 | 969 | 481 | 2390 |
Median survival (months; 95% CI) | 44.7 (40.9–50.5) | 24.1 (21.9–26.0) | 9.5 (7.2–14.1) | 28.2 (25.9–30.7) | 16.2 (14.5–20.2) | 28.5 (26.3–30.5) |
p-value < 0.001 | p-value < 0.001 | - | ||||
1-year survival (%; 95% CI) | 85.0 (82.4–87.6) | 69.1 (66.6–71.7) | 44.3 (35.0–53.7) | 74.3 (71.4–77.2) | 58.0 (53.1–62.9) | 73.3 (71.4–75.2) |
3-year survival (%; 95 %CI) | 57.3 (53.4–61.3) | 37.1 (34.1–40.1) | 9.6 (3.1–16.2) | 42.0 (38.3–45.7) | 26.3 (21.4–31.2) | 42.9 (40.5–45.2) |
5-year survival (%; 95% CI) | 35.6 (31.2–40.1) | 23.4 (20.4–26.4) | 3.2 (0.0–8.8) | 26.5 (22.7–30.3) | 16.5 (11.8–21.2) | 26.8 (24.3–29.2) |
10-year survival (%; 95% CI) | 13.5 (8.1–18.9) | 13.8 (10.5–17.0) | 0 (0.0–0.0) | 15.1 (11.0–19.1) | 0 (0.0–0.0) | 12.7 (9.8–15.7) |
Progression-Free Survival (PFS) | ||||||
n | 806 | 1450 | 134 | 969 | 481 | 2390 |
Median survival (months; 95% CI) | 17.0 (15.4–18.8) | 9.0 (8.3–9.5) | 4.5 (3.9–6.1) | 10.1 (9.4–11.4) | 6.2 (5.5–7.5) | 10.6 (9.9–11.5) |
p-value < 0.001 | p-value < 0.001 | - | ||||
1-year survival (%; 95% CI) | 61.8 (58.3–65.3) | 40.7 (38.0–43.4) | 20.8 (13.1–28.5) | 45.1 (41.8–48.4) | 31.6 (27.1–36.1) | 46.9 (44.7–49.0) |
3-year survival (%; 95%CI) | 25.1 (21.7–28.5) | 13.0 (11.0–15.1) | 1.8 (0.0–5.1) | 15.9 (13.2–18.6) | 7.0 (4.2–9.7) | 16.6 (14.9–18.4) |
5-year survival (%; 95% CI) | 10.4 (7.7–13.2) | 8.0 (6.2–9.8) | 1.8 (0.0–5.1) | 9.7 (7.3–12.0) | 4.5 (2.1–6.9) | 8.4 (7.0–9.9) |
10-year survival (%; 95% CI) | 3.7 (1.2–6.2) | 0 (0.0–0.0) | 0 (0.0–0.0) | 0 (0.0–0.0) | 0 (0.0–0.0) | 3.7 (2.1–5.3) |
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Fiala, O.; Finek, J.; Poprach, A.; Melichar, B.; Kopecký, J.; Zemanova, M.; Kopeckova, K.; Mlcoch, T.; Dolezal, T.; Capkova, L.; et al. Outcomes According to MSKCC Risk Score with Focus on the Intermediate-Risk Group in Metastatic Renal Cell Carcinoma Patients Treated with First-Line Sunitinib: A Retrospective Analysis of 2390 Patients. Cancers 2020, 12, 808. https://doi.org/10.3390/cancers12040808
Fiala O, Finek J, Poprach A, Melichar B, Kopecký J, Zemanova M, Kopeckova K, Mlcoch T, Dolezal T, Capkova L, et al. Outcomes According to MSKCC Risk Score with Focus on the Intermediate-Risk Group in Metastatic Renal Cell Carcinoma Patients Treated with First-Line Sunitinib: A Retrospective Analysis of 2390 Patients. Cancers. 2020; 12(4):808. https://doi.org/10.3390/cancers12040808
Chicago/Turabian StyleFiala, Ondrej, Jindrich Finek, Alexandr Poprach, Bohuslav Melichar, Jindrich Kopecký, Milada Zemanova, Katerina Kopeckova, Tomas Mlcoch, Tomas Dolezal, Lenka Capkova, and et al. 2020. "Outcomes According to MSKCC Risk Score with Focus on the Intermediate-Risk Group in Metastatic Renal Cell Carcinoma Patients Treated with First-Line Sunitinib: A Retrospective Analysis of 2390 Patients" Cancers 12, no. 4: 808. https://doi.org/10.3390/cancers12040808
APA StyleFiala, O., Finek, J., Poprach, A., Melichar, B., Kopecký, J., Zemanova, M., Kopeckova, K., Mlcoch, T., Dolezal, T., Capkova, L., & Buchler, T. (2020). Outcomes According to MSKCC Risk Score with Focus on the Intermediate-Risk Group in Metastatic Renal Cell Carcinoma Patients Treated with First-Line Sunitinib: A Retrospective Analysis of 2390 Patients. Cancers, 12(4), 808. https://doi.org/10.3390/cancers12040808