Open AccessPrognosis of metastatic renal cell carcinoma with first‐line interferon‐α therapy in the era of molecular‐targeted therapy
Author(s) -
Kawano Yoshiaki,
Takahashi Wataru,
Eto Masatoshi,
Kamba Tomomi,
Miyake Hideaki,
Fujisawa Masato,
Kamai Takao,
Uemura Hirotsugu,
Tsukamoto Taiji,
Azuma Haruhito,
Matsubara Akio,
Nishimura Kazuo,
Nakamura Tsuyoshi,
Ogawa Osamu,
Naito Seiji
Publication year - 2016
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.12951
Subject(s) - medicine , renal cell carcinoma , oncology , proportional hazards model , hazard ratio , multivariate analysis , univariate analysis , targeted therapy , cohort , gastroenterology , cancer , confidence interval
The RCC ‐ SELECT study showed the correlation between single nucleotide polymorphisms ( SNP ) in STAT 3 gene and survival in metastatic renal cell carcinoma ( mRCC ) patients with first‐line interferon‐α ( IFN ‐α). In that study, even patients with STAT 3 SNP linked to shorter overall survival ( OS ) exhibited remarkably improved prognosis. All 180 patients evaluated in the above study were further analyzed for correlation between OS and demographics/clinicopathological parameters. OS was estimated using the Kaplan–Meier method. Associations between OS and potential prognostic factors were assessed using the log‐rank test and the Cox proportional hazards model. The median OS was 42.8 months. Univariate analysis showed that worse Eastern Cooperative Oncology Group‐performance status ( ECOG ‐ PS ), high T stage, regional lymph node metastasis, distant metastasis, higher grade, infiltrative growth pattern, the presence of microscopic vascular invasion ( MVI ), hypercalcemia, anemia, thrombocytopenia and elevated C‐reactive protein were significantly associated with OS . Multivariate analysis revealed that ECOG ‐ PS (hazard ratio [ HR ] = 3.665, P = 0.0004), hypercalcemia ( HR = 6.428, P = 0.0005) and the presence of MVI ( HR = 2.668, P = 0.0109) were jointly significant poor prognostic factors. This is the first study analysing prognostic factors of mRCC patients with first‐line IFN ‐α using large cohort of the prospective study. The present study suggests that first‐line IFN ‐α is still a useful therapy for mRCC even in the era of molecular targeted therapy.