Prognostic Factors Associated with the Response to Sunitinib in Patients with Metastatic Renal Cell Carcinoma

Abstract

Objective: We investigated the prognostic clinicopathologic factors associated with overall survival (OS) and progression-free survival (PFS) in the once-daily continuous administration of first-line sunitinib in a consecutive cohort of Turkish patients with metastatic renal cell carcinoma (RCC). Methods: The study enrolled 77 Turkish patients with metastatic RCC who received sunitinib in a continuous once-daily dosing regimen between April 2006 and April 2011. Univariate analyses were performed using the log-rank test. Results: Median follow-up was 18.5 months. In univariate analyses, poor PFS and OS were associated with 4 of the 5 factors in the Memorial Sloan–Kettering Cancer Center (MSKCC) score: Eastern Cooperative Oncology Group performance status of 2 or higher, low hemoglobin, high corrected serum calcium, and high lactate dehydrogenase. In addition to those factors, hypoalbuminemia, more than 2 metastatic sites, liver metastasis, non–clear cell histology, and the presence of sarcomatoid features on pathology were also associated with poor PFS; and male sex, hypoalbuminemia, prior radiotherapy, more than 2 metastatic sites, lung metastasis, nuclear grade of 3 or 4 for the primary tumour, and the presence of sarcomatoid features were also associated with poorer OS. The application of the MSKCC model distinctly separated the PFS and OS curves (p < 0.001). Conclusions: Our study identified prognostic factors for PFS and OS with the use sunitinib as first-line metastatic RCC therapy and confirmed that the MSKCC model still appears to be valid for predicting survival in metastatic RCC in the era of molecular targeted therapy.