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Potential Prognostic Biomarkers in Metastatic Kidney Cancer

By: Joshua D. Madera, MS
Posted: Friday, January 1, 2021

For patients with metastatic renal cell carcinoma receiving tyrosine kinase inhibitor (TKI) therapy, estimated glomerular filtration rate (eGFR) and proteinuria level may be important biomarkers that predict survival outcomes, according to a study published in Cancer Control. “TKI-induced renal impairment could indicate for longer survival and better tumor response and provide valuable information for the individual treatment of metastatic renal cell carcinoma patients,” explained Pengfei Shen, PhD, of West China Hospital, Sichuan University, Chengdu, People’s Republic of China, and colleagues.

A total of 110 patients with metastatic renal cell carcinoma were enrolled in the study. All patients were being treated with TKIs. Patients’ blood urea nitrogen (BUN), proteinuria level, and eGFR were measured at baseline and during treatment with TKIs. Renal impairment was defined as BUN greater than 7.1 mol/L, a proteinuria level greater than 0.3 g/L, and/or an eGFR less than 60 mL/min/1.73m2.

The study findings revealed renal impairment due to abnormal BUN (22.7%), proteinuria (27.3%), and eGFR (25.5%) at baseline, which increased to 41.8%, 58.2%, and 50.0% following treatment with TKIs, respectively. In addition, results from the survival analysis revealed a positive association between survival outcomes and post-treatment renal impairment. Furthermore, for patients with absent renal impairment at baseline, there was a significant association between overall survival and post-treatment eGFR (P = .004), a decrease in eGFR of more than 10% (P = .012), proteinuria (P = .014), and elevated proteinuria (P = .006).

For patients who initially had symptoms of renal impairment that improved with TKI therapy, there was no significant association with progression-free or overall survival. Moreover, patients with a decrease in eGFR of more than 10% (P = .016) within 1 year following TKI therapy was deemed a positive biomarker for overall survival.

Disclosure: The authors reported no conflicts of interest.



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