title: [Prognostic factors for metastatic renal cell carcinoma treated with second-line targeted therapies].
abstract: OBJECTIVE
  To assess the prognostic value of clinical and biological features in patients treated with second-line targeted therapies (TT) for a metastatic renal cell carcinoma (mRCC).
  
  
  METHODS
  A retrospective study was performed including 60 patients treated with second-line TT from 2006 to 2013. Clinical and biological features were collected, including TT-induced toxicities, Heng and MSKCC prognostic scores, and renal function. Overall survival (OS) and progression-free survival (PFS) were assessed using univariate and multivariate analysis.
  
  
  RESULTS
  The median age was 61 years [39-81]. MSKCC and Heng scores were significantly prognostic for OS and PFS (P<0.05). Hypo-albuminemia, anemia and brain metastasis were associated with poorer OS and PFS (P<0.05). Severe induced toxicities had a prognostic impact with higher OS (26 months vs 10 months, P=0.003) and PFS (5 months vs 4 months, P=0.047). Renal function impairment at the initiation of the second line was also associated with higher survival (OS=24 months vs 9 months, P=0.035 and PFS=7 months vs 4 months, P=0.043). On multivariate analysis, induced toxicity was found as an independent factor of good prognosis for OS (HR=0.36; P=0.01).
  
  
  CONCLUSIONS
  Our results suggested that renal function impairment and TT-induced toxicities in the second line of treatment for mRCC have a potential prognostic interest as it had previously been reported for the first line of TT.
  
  
  METHODS
  5.
authors.affiliation: Service d'urologie et transplantation, centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: J D
authors.initials: JD
authors.lastname: Rebibo
authors.affiliation: Service d'urologie et transplantation, centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France; Équipe de recherche d'oncologie normande (IRON), centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Pfister
authors.affiliation: Service d'urologie et transplantation, centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Giwerc
authors.affiliation: Service d'urologie et transplantation, centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Defortescu
authors.affiliation: Unité d'oncologie urologique et digestive, centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France; Service d'oncologie médicale, centre Henri-Becquerel, rue d'Amiens, 76000 Rouen, France.
authors.forename: S
authors.initials: S
authors.lastname: Gouerant
authors.affiliation: Équipe de recherche d'oncologie normande (IRON), centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France; Unité d'oncologie urologique et digestive, centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France; Service d'oncologie médicale, centre Henri-Becquerel, rue d'Amiens, 76000 Rouen, France.
authors.forename: F
authors.initials: F
authors.lastname: Di Fiore
authors.affiliation: Service d'urologie et transplantation, centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France; Équipe de recherche d'oncologie normande (IRON), centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France; Unité d'oncologie urologique et digestive, centre hospitalier et universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France. Electronic address: fx_nouhaud@hotmail.fr.
authors.forename: F-X
authors.initials: FX
authors.lastname: Nouhaud
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D018572:Disease-Free Survival; D000068338:Everolimus / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000008:administration & dosage; D011379:Prognosis; D011758:Pyrroles / Q000008:administration & dosage; D012189:Retrospective Studies; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077157:Sorafenib; D000077210:Sunitinib; D016896:Treatment Outcome
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: Cancer du rein métastatique; Facteurs pronostiques; Induced toxicity; Metastatic renal cell carcinoma; Prognostic factors; Survie; Survival; Targeted therapies; Thérapies ciblées; Toxicité induite