title: [Prognostic value of toxicities induced by targeted therapies in patients treated for a metastatic renal cell carcinoma].
abstract: OBJECTIVE
  To assess the prognostic value of clinical and biological variables in the era of targeted therapies, especially induced toxicity in patients treated for metastatic renal cell carcinoma (RCC).
  
  
  METHODS
  A retrospective single-center study was performed in patients treated in our center from 2006 to 2012. The clinical and biological variables and toxicity data were retrospectively collected. Survival rates were calculated using the Kaplan-Meier method and compared by the Log-Rank test. Multivariate analysis was also performed using the Cox model.
  
  
  RESULTS
  One hundred and two patients were included, with a median follow-up of 20 months. The median overall survival (OS) was 21 months, and 6 months for the progression free survival (PFS). As expected, the variables included in the Mozter prognostic score had a significant impact on OS (P < 0.0001) and PFS (P < 0.0001). However, hypoalbuminemia (P < 0.0001), brain metastasis (P = 0.003) and the absence of nephrectomy (P < 0.0001) were found as poor prognosis factors for OS. In addition, severe toxicity (grade 3-4) was significantly associated with higher OS (P < 0.0001) and PFS (P = 0.0003) and appeared as an independent factor in multivariate analysis for OS (P = 0.02) and PFS (P = 0.01).
  
  
  CONCLUSIONS
  Severe toxicity induced by targeted therapies was found as a prognostic factor increasing significantly the survival. Further studies are needed to assess the real value of this factor in the development of sequential therapies for the treatment of RCC.
authors: Service d'urologie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France. Electronic address: fx_nouhaud@hotmail.fr.
authors: F-X
authors: FX
authors: Nouhaud
authors: Service d'urologie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors: J-D
authors: JD
authors: Rebibo
authors: Service d'anatomie et cytologie pathologique, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors: F
authors: F
authors: Blanchard
authors: Service d'anatomie et cytologie pathologique, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors: J-C
authors: JC
authors: Sabourin
authors: Service d'oncologie urologique et digestive, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France; Service d'oncologie médicale, centre Henri-Becquerel, rue d'Amiens, 76000 Rouen, France.
authors: F
authors: F
authors: Di Fiore
authors: Service d'urologie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors: C
authors: C
authors: Pfister
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D018572:Disease-Free Survival; D000068338:Everolimus; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000009:adverse effects; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000009:adverse effects; D011379:Prognosis; D011758:Pyrroles / Q000009:adverse effects; D012189:Retrospective Studies; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives; D000077157:Sorafenib; D000077210:Sunitinib; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D010671:Phenylurea Compounds; D011758:Pyrroles; D009536:Niacinamide; C401859:temsirolimus; D000068338:Everolimus; D000077157:Sorafenib; D000077210:Sunitinib; D020123:Sirolimus
keywords: Brain metastasis; Cancer du rein métastatique; Facteurs pronostiques; Induced toxicity; Metastatic renal cell carcinoma; Métastase cérébrale; Prognostic factors; Survie; Survival; Targeted therapies; Thérapies ciblées; Toxicité induite