Can Dynamic Changes During Therapy Predict Survival in Renal Cell Cancer?
Dynamic changes in prognostic markers occur in patients with clear cell renal cell carcinoma receiving vascular endothelial growth factor (VEGF)-targeted therapy, and these changes may predict overall survival, according to research published by Scott Thomas Colville Shepherd, MD, of the Royal Marsden Hospital in London, and colleagues, in the Journal of Clinical Oncology.
The team conducted a retrospective analysis of a randomized, double-blind phase II study that evaluated the VEGF inhibitor cediranib with and without saracatinib in patients with relapsed metastatic clear cell renal cell carcinoma. Saracatinib is a dual-specific inhibitor of Src and Abl.
On multivariate analysis, the investigators found three independent predictors of overall survival: Memorial Sloan Kettering Cancer Center score for metastatic renal cell carcinoma, C-reactive protein levels, and neutrophil count.
Mean C-reactive protein levels were significantly different at baseline, at 8 weeks, and at disease progression (64.9, 42.3, and 85.7 mg/L, respectively). Mean neutrophil count was significantly higher at disease progression (6.3 x 109/L) than it was at baseline (5.3 x 109/L). And a rise in C-reactive protein levels or neutrophil count at 8 weeks was found to be predictive of a poor outcome, they reported.