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The Impact of Renal Impairment on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors

PURPOSE: It remained unclear whether tyrosine kinase inhibitors (TKIs) related renal impairment had impact on the survival of patients with metastatic renal cell carcinoma (mRCC). METHODS: Clinicopathological parameters of patients with mRCC treated with TKIs were retrospectively reviewed. Blood ure...

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Autores principales: Zhang, Haoran, Zhang, Xingming, Zhu, Xudong, Ni, Yuchao, Dai, Jindong, Zhu, Sha, Sun, Guangxi, Wang, Zhipeng, Chen, Junru, Zhao, Jinge, Zeng, Hao, Li, Zi, Shen, Pengfei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480366/
https://www.ncbi.nlm.nih.gov/pubmed/33269597
http://dx.doi.org/10.1177/1073274820977143
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author Zhang, Haoran
Zhang, Xingming
Zhu, Xudong
Ni, Yuchao
Dai, Jindong
Zhu, Sha
Sun, Guangxi
Wang, Zhipeng
Chen, Junru
Zhao, Jinge
Zeng, Hao
Li, Zi
Shen, Pengfei
author_facet Zhang, Haoran
Zhang, Xingming
Zhu, Xudong
Ni, Yuchao
Dai, Jindong
Zhu, Sha
Sun, Guangxi
Wang, Zhipeng
Chen, Junru
Zhao, Jinge
Zeng, Hao
Li, Zi
Shen, Pengfei
author_sort Zhang, Haoran
collection PubMed
description PURPOSE: It remained unclear whether tyrosine kinase inhibitors (TKIs) related renal impairment had impact on the survival of patients with metastatic renal cell carcinoma (mRCC). METHODS: Clinicopathological parameters of patients with mRCC treated with TKIs were retrospectively reviewed. Blood urea nitrogen (BUN), proteinuria and estimated glomerular filtration rate (eGFR) at baseline and during TKIs treatment were recorded. BUN > 7.1mol/L, eGFR <60 ml/min/1.73m(2) and/or proteinuria level > 0.3 g/L were defined as renal impairment. eGFR and proteinuria were furtherly classified into different levels. Treatment outcomes were defined as progression-free survival (PFS) and overall survival (OS). RESULTS: At baseline, the presence of abnormal BUN, eGFR and proteinuria level were observed in 25 (22.7%), 27 (25.5%) and 30 (27.3%) patients, which increased to 46 (41.8%), 55 (50.0%) and 64 (58.2%) respectively after TKIs treatment. In the whole cohort (N = 110), survival analysis suggested that only post-treatment renal impairment was related to survival outcomes. Interestingly, sub-analysis showed that post-treatment eGFR level (p = 0.004), proteinuria (p = 0.014) and eGFR decrease >10% (p = 0.012) and elevated proteinuria compared with baseline (p = 0.006) were statistically correlated with OS among patients without RI at baseline (N = 51). On the contrary, deterioration of renal impairment after TKIs treatment in patients with renal impairment at baseline (N = 59) had no relationship with either PFS or OS. Furthermore, eGFR (p = 0.020) and eGFR decrease >10% (p = 0.016) within 1 year after TKIs therapy were potential biomarkers for OS. CONCLUSION: Dynamic changes of TKI-induced RI during TKIs treatment, especially eGFR and proteinuria level, could be considered as potential biomarkers predicting survival outcomes of mRCC patients.
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spelling pubmed-84803662021-09-30 The Impact of Renal Impairment on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors Zhang, Haoran Zhang, Xingming Zhu, Xudong Ni, Yuchao Dai, Jindong Zhu, Sha Sun, Guangxi Wang, Zhipeng Chen, Junru Zhao, Jinge Zeng, Hao Li, Zi Shen, Pengfei Cancer Control Original Research Paper PURPOSE: It remained unclear whether tyrosine kinase inhibitors (TKIs) related renal impairment had impact on the survival of patients with metastatic renal cell carcinoma (mRCC). METHODS: Clinicopathological parameters of patients with mRCC treated with TKIs were retrospectively reviewed. Blood urea nitrogen (BUN), proteinuria and estimated glomerular filtration rate (eGFR) at baseline and during TKIs treatment were recorded. BUN > 7.1mol/L, eGFR <60 ml/min/1.73m(2) and/or proteinuria level > 0.3 g/L were defined as renal impairment. eGFR and proteinuria were furtherly classified into different levels. Treatment outcomes were defined as progression-free survival (PFS) and overall survival (OS). RESULTS: At baseline, the presence of abnormal BUN, eGFR and proteinuria level were observed in 25 (22.7%), 27 (25.5%) and 30 (27.3%) patients, which increased to 46 (41.8%), 55 (50.0%) and 64 (58.2%) respectively after TKIs treatment. In the whole cohort (N = 110), survival analysis suggested that only post-treatment renal impairment was related to survival outcomes. Interestingly, sub-analysis showed that post-treatment eGFR level (p = 0.004), proteinuria (p = 0.014) and eGFR decrease >10% (p = 0.012) and elevated proteinuria compared with baseline (p = 0.006) were statistically correlated with OS among patients without RI at baseline (N = 51). On the contrary, deterioration of renal impairment after TKIs treatment in patients with renal impairment at baseline (N = 59) had no relationship with either PFS or OS. Furthermore, eGFR (p = 0.020) and eGFR decrease >10% (p = 0.016) within 1 year after TKIs therapy were potential biomarkers for OS. CONCLUSION: Dynamic changes of TKI-induced RI during TKIs treatment, especially eGFR and proteinuria level, could be considered as potential biomarkers predicting survival outcomes of mRCC patients. SAGE Publications 2020-12-03 /pmc/articles/PMC8480366/ /pubmed/33269597 http://dx.doi.org/10.1177/1073274820977143 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Paper
Zhang, Haoran
Zhang, Xingming
Zhu, Xudong
Ni, Yuchao
Dai, Jindong
Zhu, Sha
Sun, Guangxi
Wang, Zhipeng
Chen, Junru
Zhao, Jinge
Zeng, Hao
Li, Zi
Shen, Pengfei
The Impact of Renal Impairment on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors
title The Impact of Renal Impairment on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors
title_full The Impact of Renal Impairment on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors
title_fullStr The Impact of Renal Impairment on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors
title_full_unstemmed The Impact of Renal Impairment on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors
title_short The Impact of Renal Impairment on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors
title_sort impact of renal impairment on survival outcomes in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors
topic Original Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480366/
https://www.ncbi.nlm.nih.gov/pubmed/33269597
http://dx.doi.org/10.1177/1073274820977143
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