Predictive factors for response to treatment in patients with advanced renal cell carcinoma.
BACKGROUND
The analysis of predictive factors of response may aid in predicting which patients with advanced renal cell carcinoma (RCC) would be good candidates for systemic treatments.


METHODS
The expression of several biomarkers was retrospectively analyzed using immunohistochemistry (IHC), as well as 2 analytical variables in 135 patients with advanced RCC treated with cytokines (CK) and/or new targeted drugs (NTD).


RESULTS
67 patients were treated solely with NTD and 68 with CK (23 also received NTD). Univariate analysis: HIF1α did not correlate significantly with response to these drugs. Overexpression of CAIX was associated with more responses (%) to NTD (64.7 vs. 21.1; p = 0.004) and CK (22.6 vs. 0; p = 0.038). PTEN demonstrated predictive value of response to sunitinib (70.8 vs. 34.1; p = 0.005). p21 was associated with a lower response to sunitinib (35.9 vs. 65.4; p = 0.025). Thrombocytosis was not significantly associated with response to NTD, although it was with CK (0 vs. 20; p = 0.017). Neutrophilia correlated with a lower response to NTD (29.6 vs. 57.5; p = 0.045), although not with CK. Multivariate analysis: Overexpression of CAIX was an independent predictor of significantly higher response to NTD and CK; OR = 8.773 (p < 0.001).


CONCLUSIONS
Our findings highlight the usefulness of CAIX in selecting patients with advanced RCC as candidates for systemic treatment. PTEN and p21 may be important in predicting response to sunitinib. Thrombocytosis and neutrophilia correlate well with response to CK and NTD, respectively.
Department of Medical Oncology, Hospital Universitario Central de Asturias, C/ Celestino Villamil s/n, 33006, Oviedo, Asturias, Spain. carolinamuriellopez@hotmail.com
Carolina
C
Muriel López
Emilio
E
Esteban
Aurora
A
Astudillo
Pablo
P
Pardo
Jose Pablo
JP
Berros
Marta
M
Izquierdo
Guillermo
G
Crespo
Paula J
PJ
Fonseca
Miguel
M
Sanmamed
Pablo
P
Martínez-Camblor
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000071231:Carbonic Anhydrase IX; D002256:Carbonic Anhydrases / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D050759:Cyclin-Dependent Kinase Inhibitor p21 / Q000378:metabolism; D016207:Cytokines / Q000627:therapeutic use*; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D007960:Leukocyte Disorders / Q000175:diagnosis; D008875:Middle Aged; D051059:PTEN Phosphohydrolase / Q000378:metabolism; D011379:Prognosis; D013922:Thrombocytosis / Q000175:diagnosis
D000951:Antigens, Neoplasm; D000970:Antineoplastic Agents; C493956:CDKN1A protein, human; D050759:Cyclin-Dependent Kinase Inhibitor p21; D016207:Cytokines; C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human; C089226:CA9 protein, human; D000071231:Carbonic Anhydrase IX; D002256:Carbonic Anhydrases