title: Hand-foot skin reaction is associated with the clinical outcome in patients with metastatic renal cell carcinoma treated with sorafenib.
abstract: BACKGROUND
  To elucidate whether Hand-Foot skin reaction could become a biomarker of clinical outcome in patients with metastatic renal cell carcinoma treated with sorafenib, we retrospectively examined the association between the Hand-Foot skin reaction and the clinical outcome in metastatic renal cell carcinoma patients treated with sorafenib.
  
  
  METHODS
  Thirty-six Japanese metastatic renal cell carcinoma patients treated with sorafenib were enrolled and divided into the groups with or without Hand-Foot skin reaction. Patient characteristics, best tumor response, progression-free survival and adverse events were investigated and compared between these two groups.
  
  
  RESULTS
  A sorafenib-induced Hand-Foot skin reaction in metastatic renal cell carcinoma patients was observed at a significantly higher rate in patients in the favorable-risk group in the Memorial Sloan-Kettering Cancer Center risk classification, and with Eastern Cooperative Oncology Group Performance Status of one or less, prior nephrectomy, higher hemoglobin, lower lactate dehydrogenase and lower C-reactive protein. The mean best tumor response was significantly better in the group with Hand-Foot skin reaction (-16.7%) than that in the group without it (17.9%; P < 0.001). The median progression-free survival was significantly longer in the group with Hand-Foot skin reaction (4.6 months) than that in the group without it (1.5 months; P = 0.002). In multivariate analysis, only Hand-Foot skin reaction was shown to be a predictive factor of progression-free survival (hazard ratio 0.312, P = 0.010).
  
  
  CONCLUSIONS
  A sorafenib-induced Hand-Foot skin reaction in metastatic renal cell carcinoma patients emerged at a significantly higher rate in patients in the favorable-risk group in the Memorial Sloan-Kettering Cancer Center risk classification and was significantly associated with best tumor response and progression-free survival, suggesting that Hand-Foot skin reaction might be an independent predictive factor for clinical outcome in metastatic renal cell carcinoma patients treated with sorafenib.
authors: *Department of Urology, Jichi Medical University, Yakushiji 3311-1, Shimotsuke city, Tochigi 329-0498, Japan. nknkzhk@jichi.ac.jp.
authors: Kazuhiko
authors: K
authors: Nakano
authors: Kenji
authors: K
authors: Komatsu
authors: Taro
authors: T
authors: Kubo
authors: Shinsuke
authors: S
authors: Natsui
authors: Akinori
authors: A
authors: Nukui
authors: Shinsuke
authors: S
authors: Kurokawa
authors: Minoru
authors: M
authors: Kobayashi
authors: Tatsuo
authors: T
authors: Morita
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D060831:Hand-Foot Syndrome / Q000209:etiology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000601:surgery; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009536:Niacinamide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D011237:Predictive Value of Tests; D047428:Protein Kinase Inhibitors / Q000009:adverse effects; D012189:Retrospective Studies; D018570:Risk Assessment; D000077157:Sorafenib; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D006454:Hemoglobins; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D009536:Niacinamide; D002097:C-Reactive Protein; D000077157:Sorafenib; D007770:L-Lactate Dehydrogenase
keywords: Hand–Foot skin reaction; renal cell carcinoma; sorafenib; tyrosine kinase inhibitor