title: The changes of lipid metabolism in advanced renal cell carcinoma patients treated with everolimus: a new pharmacodynamic marker?
abstract: BACKGROUND
  Everolimus is a mammalian target of rapamycin (mTOR) inhibitor approved for the treatment of metastatic renal cell carcinoma (mRCC). We aimed to assess the association between the baseline values and treatmentrelated modifications of total serum cholesterol (C), triglycerides (T), body mass index (BMI), fasting blood glucose level (FBG) and blood pressure (BP) levels and the outcome of patients treated with everolimus for mRCC.
  
  
  METHODS
  177 patients were included in this retrospective analysis. Time to progression (TTP), clinical benefit (CB) and overall survival (OS) were evaluated.
  
  
  RESULTS
  Basal BMI was significantly higher in patients who experienced a CB (p=0,0145). C,T and C+T raises were significantly associated with baseline BMI (p=0.0412, 0.0283 and 0.0001). Median TTP was significantly longer in patients with T raise compared to patients without T (10 vs 6, p=0.030), C (8 vs 5, p=0.042) and C+T raise (10.9 vs 5.0, p=0.003). At the multivariate analysis, only C+T increase was associated with improved TTP (p=0.005). T raise (21.0 vs 14.0, p=0.002) and C+T increase (21.0 vs 14.0, p=0.006) were correlated with improved OS but were not significant at multivariate analysis.
  
  
  CONCLUSIONS
  C+T raise is an early predictor for everolimus efficacy for patients with mRCC.
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pantano
authors.affiliation: Department of Medical Oncology, AOU Ospedali Riuniti, Università Politecnica delle Marche, Piazza Roma, 22,60121 Ancona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.affiliation: Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
authors.affiliation: Department of Medical Oncology, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
authors.forename: Mimma
authors.initials: M
authors.lastname: Rizzo
authors.affiliation: Department of Oncology, Oncology Unit B, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Iacovelli
authors.affiliation: Department of Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Viale Camillo Golgi, 19, 27100 Pavia, Italy.
authors.forename: Camillo
authors.initials: C
authors.lastname: Porta
authors.affiliation: Department of Clinical and Specialist Sciences, Urology, Università Politecnica delle Marche, Piazza Roma, 22, 60121, Ancona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Conti
authors.affiliation: Department of Medical Oncology, San Camillo De Lellis Hospital, Via John Fitzgerald Kennedy, 17, 02100 Rieti, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lugini
authors.affiliation: Department of Medical Oncology, Medical Oncology A, Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00128 Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Milella
authors.affiliation: Department of Medical Oncology, Azienda Ospedaliera Universitaria Pisana, Via Roma, 67, 56126 Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Galli
authors.affiliation: Department of Medical Oncology, Institute for Cancer Research & Treatment (IRCC), Strada Provinciale, 142, 10060 Candiolo, Torino, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Guida
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Silletta
authors.affiliation: Department of Medical Oncology, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Schinzari
authors.affiliation: Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Verzoni
authors.affiliation: Department of Oncology, Oncology Unit B, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Modica
authors.affiliation: Department of Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Pierfilippo
authors.initials: P
authors.lastname: Crucitti
authors.affiliation: Department of Medical Oncology, San Camillo De Lellis Hospital, Via John Fitzgerald Kennedy, 17, 02100 Rieti, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Rauco
authors.affiliation: Department of Medical Oncology, Medical Oncology A, Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00128 Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Felici
authors.affiliation: Department of Medical Oncology, Institute for Cancer Research & Treatment (IRCC), Strada Provinciale, 142, 10060 Candiolo, Torino, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Ballatore
authors.affiliation: Department of Medical Oncology, AOU Ospedali Riuniti, Università Politecnica delle Marche, Piazza Roma, 22,60121 Ancona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tonini
authors.affiliation: Department of Medical Oncology, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Carteni
authors.affiliation: Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002784:Cholesterol / Q000097:blood; D018450:Disease Progression; D000068338:Everolimus / Q000627:therapeutic use*; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D050356:Lipid Metabolism / Q000502:physiology*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol; D000068338:Everolimus