title: Prognostic factors of response or failure of treatment in patients with metastatic renal carcinomas treated by cytokines: a report from the Groupe Français d'Immunothérapie.
abstract: Interleukin-2 (IL2) or/and interferon (IFN) are routinely used for treating patients with metastatic renal cell cancer. However, results are disappointing since most patients experience treatment failure. Within 6 years, the Groupe Français d'Immunothérapie enrolled 782 patients in successive multicenter trials using cytokine regimens. Univariate and multivariate analyses were performed on this large prospective database to identify prognostic factors for treatment response or failure. We identified two independent factors predictive of response to cytokine treatment: having only one metastatic organ site and receiving a combination of cytokine treatments. We also identified four independent factors predictive of rapid progression under treatment: presence of hepatic metastases, short interval from renal tumor to metastases (<1 year), more than one metastatic site and elevated neutrophil counts. Patients who combine at least three of these factors have over 80% probability of rapid progression despite treatment. We think that these results must be taken into account for cytokine treatment decision.
authors.affiliation: Department of Biostatistics, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08 France. negrier@lyon.fnclcc.fr
authors.forename: Sylvie
authors.initials: S
authors.lastname: Negrier
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gomez
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Douillard
authors.forename: Alain
authors.initials: A
authors.lastname: Ravaud
authors.forename: Christine
authors.initials: C
authors.lastname: Chevreau
authors.forename: Murielle
authors.initials: M
authors.lastname: Buclon
authors.forename: David
authors.initials: D
authors.lastname: Perol
authors.forename: Christine
authors.initials: C
authors.lastname: Lasset
authors.forename: Bernard
authors.initials: B
authors.lastname: Escudier
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D007376:Interleukin-2 / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D007376:Interleukin-2; D007372:Interferons