scholarly journals C‐reactive protein flare‐response predicts long‐term efficacy to first‐line anti‐PD‐1‐based combination therapy in metastatic renal cell carcinoma

2021 ◽  
Vol 10 (12) ◽  
Author(s):  
Niklas Klümper ◽  
Philipp Schmucker ◽  
Oliver Hahn ◽  
Benedikt Höh ◽  
Angelika Mattigk ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Combination Therapy ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
C Reactive Protein ◽  
First Line ◽  
Reactive Protein ◽  
Flare Response

Prognostic impact of baseline serum C-reactive protein in metastatic renal cell carcinoma treated with sunitinib.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 425-425 ◽  
Author(s):  
Vano Yann-Alexandre ◽  
Benoit Beuselinck ◽  
Pascal Wolter ◽  
Corine Teghom ◽  
Debruyne Philip ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Serum Lactate Dehydrogenase ◽  
C Reactive Protein ◽  
First Line ◽  
Baseline Serum ◽  
Reactive Protein ◽  
Serum Crp

425 Background: The aim of our study was to determine whether baseline serum C-reactive protein (CRP) level could predict outcome of patients with metastatic renal cell carcinoma (mRCC) receiving sunitinib in first-line setting. Methods: We reviewed the charts of 187 consecutive patients in three hospitals in Belgium and France who started sunitinib as first targeted treatment between 2005 and 2012. Data were collected from each individual patient file on known prognostic factors for mRCC and anatomical location of metastatic sites, response rate, progression free survival (PFS), and overall survival (OS). Results: 187 eligible patients were identified by retrospective chart review. Median PFS was 26 months in the group with baseline CRP within normal limits (≤5 mg/l) versus 8 months in the group with elevated baseline CRP (>5 mg/l) (p < 0.0001). Median OS was 50 versus 12 months respectively (p < 0.0001). In the group with normal baseline CRP, 69% of patients experienced a partial response (PR) compared to 31% of patients in the group with elevated baseline CRP (p < 0.0001). On multivariate analysis, taking into account baseline neutrophil count, platelet count, ECOG PS, serum lactate dehydrogenase (LDH) activity, hemoglobin levels, corrected serum calcium levels, interval between initial diagnosis of RCC and start of systemic therapy </≥12 months, presence/absence of liver metastases or bone metastases and prior nephrectomy, baseline serum CRP-level was found to be an independent variable associated with poor PFS (p = 0.01) and OS (p < 0.0001). Conclusions: Baseline serum CRP level is an independent parameter correlated with ORR, PFS and OS in mRCC patients treated with sunitinib in first-line. [Table: see text]

scholarly journals Impact of C-reactive protein flare-response on oncological outcomes in patients with metastatic renal cell carcinoma treated with nivolumab

2021 ◽  
Vol 9 (2) ◽  
pp. e001564
Author(s):  
Shohei Fukuda ◽  
Kazutaka Saito ◽  
Yosuke Yasuda ◽  
Toshiki Kijima ◽  
Soichiro Yoshida ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Objective Response ◽  
Tumor Shrinkage ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Oncological Outcomes ◽  
Flare Response

BackgroundThe dynamic change in C-reactive protein (CRP) levels, CRP kinetics, is a prognostic factor for metastatic renal cell carcinoma (mRCC) in the tyrosine kinase inhibitor era. We investigated the impact of early CRP kinetics on the efficacy of nivolumab in patients with mRCC.MethodsWe performed a retrospective analysis of 42 mRCC patients who were treated with nivolumab as a second-line or later therapy between 2016 and 2019. All patients had received previous TKI therapy. Patients were divided into three groups based on their early CRP kinetics: CRP levels increased to more than double compared with baseline within 1 month after initiation of nivolumab (flare) and then decreased to a lower value than baseline within 3 months (CRP flare-responders); CRP levels decreased by ≥30% within 3 months without “flare” (CRP responders); and the remaining patients (non-CRP responders). The maximum tumor shrinkage, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated. The association of the early CRP kinetics and oncological outcomes was assessed.ResultsThe median follow-up period was 8 months. The median baseline CRP level was 23 mg/L. CRP flare-responders, CRP responders, and non-CRP responders included 11 (26%), 15 (36%), and 16 (38%) patients, respectively. Thirteen patients (31%) died of mRCC. The maximum changes in target lesions from baseline of CRP flare-responder, CRP-responder, and non-CRP responder groups were −38%, −13%, and 16%, on average, respectively (p<0.001). ORRs of these three groups were 73%, 27%, and 6%, respectively (p<0.001). The median PFS values of each group were not reached, 12 months, and 2.4 months (p=0.005), and the median OS values were not reached, not reached, and 12 months (p=0.048). In a multivariate analysis, early CRP kinetics was a significant independent factor for objective response, PFS, and OS (p<0.001, p=0.004, and p=0.006, respectively).ConclusionsCRP flare-response was associated with significant tumor shrinkage and improved survival outcomes in patients with mRCC who were treated with nivolumab. Early CRP kinetics could be useful for evaluating nivolumab treatment efficacy.

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