Bone metastasis is associated with poor prognosis in metastatic papillary renal cell carcinoma patients treated with first agent angiogenesis inhibitors.

Abstract

OBJECTIVE:

Papillary renal cell carcinoma (papRCC) is a rare (10%-15%) subtype of renal cancer. Few prognostic biomarkers have been described in metastatic papRCC (m-papRCC) patients treated with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs). We aimed to study the prognostic impact of bone metastases (BM) on response rate, progression-free and overall survival (PFS and OS) in patients with m-papRCC treated with first agent VEGFR-TKIs.

PATIENTS AND METHODS:

A multicentric, retrospective analysis of patient records was conducted. BM were detected by computed tomography and/or bone scintigraphy. The International Metastatic RCC Database Consortium (IMDC) score was calculated at start of first agent VEGFR-TKI treatment.

RESULTS:

Forty-nine patients were included. Best objective response was partial response in 20%, stable disease in 60% and early progressive disease in 20% of patients. Median PFS (mPFS) was 6.0 months and median OS (mOS) 14.0 months after start of first agent VEGFR-TKI. The IMDC score correlated with mOS: 77.5 months in good, 17.0 months in intermediate and 8.0 months in poor risk patients (P = 0.002). Patients with BM had a poorer outcome compared to patients without BM: mPFS was 4.0 vs. 7.0 months (P = 0.006) and mOS 7.5 vs. 19.0 months (P = 0.002). On bivariate analysis, the presence of BM was independently associated with PFS (P = 0.02) and OS (P = 0.049), independent of the IMDC risk groups.

CONCLUSION:

In m-papRCC patients treated with first agent VEGFR-TKIs, the presence of BM is an unfavorable prognostic factor, associated with shorter PFS and OS.

• Authors: Lorenz Haaker, Loesia Tryssesoone, Inne Renders, Annelies Verbiest, Evelyne Lerut, Marcella Baldewijns, Claire Bourgain, Eduard Roussel, Heidi Van den Bulck, Wim Wynendaele, Brigitte Laguerre, Nathalie Rioux-Leclercq, Stéphane Oudard, Annouschka Laenen, Philip R Debruyne, Maarten Albersen, Benoit Beuselinck
• Journal: Urologic oncology (Urol Oncol) Vol. 38 Issue 8 Pg. 686.e1-686.e9 (08 2020) ISSN: 1873-2496 [Electronic] United States
• PMID: 32430250 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Angiogenesis Inhibitors
• Indazoles
• Pyrimidines
• Sulfonamides
• pazopanib
• Sorafenib
• Axitinib
• Sunitinib

Topics

• Adult
• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• Axitinib (therapeutic use)
• Bone Neoplasms (mortality, secondary)
• Carcinoma, Renal Cell (drug therapy, mortality, secondary)
• Disease-Free Survival
• Female
• Humans
• Indazoles
• Kidney Neoplasms (drug therapy, mortality, pathology)
• Male
• Middle Aged
• Prognosis
• Pyrimidines (therapeutic use)
• Retrospective Studies
• Sorafenib (therapeutic use)
• Sulfonamides (therapeutic use)
• Sunitinib (therapeutic use)
• Survival Rate
• Treatment Outcome