title: Clinical and laboratory prognostic factors in patients with metastatic renal cell carcinoma treated with sunitinib and sorafenib after progression on cytokines.
abstract: OBJECTIVE
  The aim of this retrospective study was to analyze prognostic factors in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors (TKIs) sunitinib or sorafenib after progression on cytokine therapy.
  
  
  METHODS
  A national database of patients treated with targeted agents was used as the data source. A total of 319 patients treated with sunitinib (n = 181) or sorafenib (n = 138) after progression on cytokine therapy were analyzed.
  
  
  RESULTS
  Prognostic factors significantly associated with poor overall survival in a multivariable Cox model included the time from diagnosis to the start of treatment with TKIs<1 year, increased neutrophil counts, increased lactate dehydrogenase, and Eastern Oncology Cooperative Group performance status 2 or higher. The parameters showing statistically significant association with progression-free survival included time from diagnosis to the beginning of treatment with TKI<1 year, increased lactate dehydrogenase, and Eastern Oncology Cooperative Group performance status 2 or higher. We have also validated the International Metastatic Renal Cell Carcinoma Database Consortium prognostic model in our cohort of patients.
  
  
  CONCLUSIONS
  We demonstrate that the International Database Consortium prognostic model performs well for European patients treated with TKIs, including sunitinib or sorafenib, after progression on cytokines and suggest that a reduction from original 6 down to 4 parameters is possible.
authors: Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors: Alexandr
authors: A
authors: Poprach
authors: Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
authors: Tomas
authors: T
authors: Pavlik
authors: Department of Oncology, Palacky University Medical School and Teaching Hospital, Olomouc, Czech Republic.
authors: Bohuslav
authors: B
authors: Melichar
authors: Department of Oncology, University Hospital of Motol, Charles University, Prague, Czech Republic.
authors: Katerina
authors: K
authors: Kubackova
authors: Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
authors: Zbynek
authors: Z
authors: Bortlicek
authors: Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors: Marek
authors: M
authors: Svoboda
authors: Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors: Radek
authors: R
authors: Lakomy
authors: Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors: Rostislav
authors: R
authors: Vyzula
authors: Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors: Igor
authors: I
authors: Kiss
authors: Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
authors: Ladislav
authors: L
authors: Dusek
authors: Department of Oncology and 1st Faculty of Medicine, Thomayer Hospital and Charles University, Prague, Czech Republic. Electronic address: tomas.buchler@ftn.cz.
authors: Tomas
authors: T
authors: Buchler
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D016207:Cytokines / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007211:Indoles / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000008:administration & dosage; D011379:Prognosis; D011758:Pyrroles / Q000008:administration & dosage; D012189:Retrospective Studies; D000077157:Sorafenib; D000077210:Sunitinib; D015996:Survival Rate
chemical_list: D016207:Cytokines; D007211:Indoles; D010671:Phenylurea Compounds; D011758:Pyrroles; D009536:Niacinamide; D000077157:Sorafenib; D000077210:Sunitinib
keywords: prognosis; renal cell carcinoma; sorafenib; sunitinib; survival