Prognostic Value of Baseline Serum C-Reactive Protein Level in Intermediate-Risk Group Patients With Metastatic Renal-Cell Carcinoma Treated by First-Line Vascular Endothelial Growth Factor–Targeted Therapy

• Published in: Clinical genitourinary cancer 2018-08, Vol.16 (4), p.e927-e933
• Main Authors: Takamatsu, Kimiharu, Mizuno, Ryuichi, Omura, Minami, Morita, Shinya, Matsumoto, Kazuhiro, Shinoda, Kazunobu, Kosaka, Takeo, Takeda, Toshikazu, Shinojima, Toshiaki, Kikuchi, Eiji, Asanuma, Hiroshi, Oyama, Masafumi, Mikami, Shuji, Oya, Mototsugu
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Agents - pharmacology; Antineoplastic Agents - therapeutic use; Biomarker; Biomarkers, Tumor - analysis; C-Reactive Protein - analysis; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - metabolism; Female; Humans; International Metastatic Renal Cell Carcinoma Database Consortium Model; Kidney cancer; Kidney Neoplasms - drug therapy; Kidney Neoplasms - metabolism; Male; Middle Aged; Molecular Targeted Therapy - methods; Molecular targeted drug; Prognosis; Retrospective Studies; Survival Analysis; Treatment Outcome; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Young Adult
• ISSN: 1558-7673; 1938-0682
• DOI: 10.1016/j.clgc.2018.03.012

Because accumulating evidence underlines the association of systemic inflammation with metastatic renal-cell carcinoma (mRCC) progression, we evaluated baseline C-reactive protein (CRP) levels as a prognostic marker in 107 intermediate-risk mRCC patients treated with first-line targeted therapy. Baseline CRP could be a biomarker correlated with overall survival in the intermediate-risk group. Its cost efficacy and availability make CRP a helpful tool for reclassifying the intermediate-risk group. Almost half of patients with metastatic renal-cell carcinoma (mRCC) are classified as intermediate risk by the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model. The aim of this study was to evaluate whether baseline C-reactive protein (CRP) levels predict overall survival (OS) in intermediate-risk group mRCC patients. Data from 107 intermediate-risk group mRCC patients receiving first-line targeted therapy were retrospectively reviewed. We evaluated the correlation between baseline CRP levels as well as other indices and OS. Of the 107 patients with intermediate-risk disease, 46 patients (43%) were classified as having elevated CRP levels. The elevation of pretreatment serum CRP levels was the independent prognostic factor of OS in patients with intermediate risk (hazard ratio, 4.609; P = .001). The 1- and 3-year survival rates of patients with intermediate–nonelevated CRP were 90.0% and 64.7% compared to the favorable-risk group, at 92.1% and 68.5%, respectively. In contrast, the 1- and 3-year survival rates of patients with intermediate–elevated CRP were 80.5% and 37.4% compared to the poor-risk group, at 65.2% and 24.2%, respectively. Baseline CRP levels could divide mRCC patients in the intermediate-risk group into 2 prognostic subgroups.