Clinical resistance predictors to first-line VEGFR-TKI monotherapy for metastatic renal cell carcinoma: a retrospective multicenter real-life case series  

作　　者：Gaetano Pezzicoli Silvana Quaglini Valentina Tibollo Melissa Bersanelli Camillo Porta Mimma Rizzo 

机构地区：[1]Department of Interdisciplinary Medicine,University of Bari"Aldo Moro",Bari 70124,Italy [2]Department of Electrical,Computer and Biomedical Engineering,University of Pavia,Pavia 27100,Italy [3]Laboratory of Informatics and Systems Engineering for Clinical Research,Scientific Clinical Institute Maugeri(ICS Maugeri),Pavia 27100,Italy [4]Medical Oncology Unit,University Hospital of Parma,Parma 43121,Italy [5]Division of Translational Oncology,Scientific Clinical Institute Maugeri(ICS Maugeri),Pavia 27100,Italy [6]Medical Oncology Unit,University Hospital-Polyclinic of Bari,Bari 70124,Italy

出　　处：《Journal of Cancer Metastasis and Treatment》2023年第1期445-458,共14页癌症转移与治疗（英文版）

摘　　要：Aim:For many years,systemic treatment of metastatic Renal Cell Carcinoma(mRCC)was based on sequential targeted agent monotherapies.In this real-life case series,we evaluated easily accessible clinical factors useful for disease course prediction.Methods:We exploited patients'clinical pathological characteristics and systemic treatment outcomes in a real-world population of 365 mRCC patients who received sequential monotherapies in the targeted therapy era,and we identified an early progressors subpopulation,resistant to first-line VEGFR-TKI monotherapy in less than 6 months.Results:Early progressors(n=124)show a far worse OS compared with patients progressing beyond the sixth month of therapy(13.5 vs.44.8 months,P-value<0.0001,HR=0.41,95%CI:0.29-0.53).However,these patients did not show far worse performance in second and third-line settings compared to first-line responders.In the univariate analysis,IMDC risk class,sarcomatoid features,and Systemic Inflammation Index(SII)were correlated with first-line therapy Progression-Free Survival(PFS1).In multivariate analysis,variables correlated with first-line outcome were IMDC risk class,histotype,and number of metastatic sites at the diagnosis.Conclusion:Real-world data can contribute to developing easy-to-use prognostic factors associated with refractory disease that could support clinicians in identifying the most appropriate treatment strategy for each patient.

关 键 词：Renal cell carcinoma targeted therapy tyrosine kinase inhibitor drug resistance early progressor rapidly progressive prognostic factor real-world data 

分 类 号：R737.11[医药卫生—肿瘤]