Biomolecules & Biomedicine (Jun 2024)

Which factors help to determine the long-term response to first-line tyrosine kinase inhibitors in patients with metastatic renal cell carcinoma: A Turkish multi-centre study

  • Nargiz Majidova,
  • Mustafa Seyyar,
  • Demet Işık Bayraktar,
  • Gülhan Dinç,
  • Elfag İsgandarov,
  • Javid Huseynov,
  • Alper Yaşar,
  • Abdussamet Çelebi,
  • Nadiye Sever,
  • Erkam Kocaaslan,
  • Pınar Erel,
  • Yeşim Ağyol,
  • Ali Kaan Güren,
  • Rukiye Arıkan,
  • Selver Işık,
  • Özlem Ercelep,
  • Güzin Demirağ,
  • Umut Kefeli,
  • Osman Köstek,
  • İbrahim Vedat Bayoğlu,
  • Murat Sarı

DOI
https://doi.org/10.17305/bb.2024.10512

Abstract

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Many developing countries lack access to recommended first-line treatments for metastatic renal cell carcinoma (mRCC), such as immune checkpoint inhibitors (ICIs) or ICI-tyrosine kinase inhibitor (TKI) combinations. As a result, predictive markers are necessary to identify patients who may benefit from single-agent TKIs for long-term response. This study aims to identify such parameters. This was a multi-centre, retrospective study of patients with mRCC who were undergoing first-line treatment with sunitinib or pazopanib. Patients who had been diagnosed with mRCC and had not experienced disease progression for 36 months or more were deemed to have achieved a long-term response. Predictive clinical and pathological characteristics of patients who did not experience long-term disease progression were investigated. A total of 320 patients from four hospitals were included in the study. The median age of the patients was 60 years (range 20-89 years). According to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk classification, 109 patients were classified as having favourable risk and 211 were in the intermediate-poor risk group. The median progression-free survival (PFS) and overall survival (OS) for all patients were 12.5 months and 76.4 months, respectively. In the long-term responder’s group, the median PFS was 78.4 months. Among all patients, prior nephrectomy, the Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) <1, and the absence of brain metastasis were predictive factors for long-term response. For patients in the favourable risk group, the lack of brain metastasis was a predictor of long-term response. In the intermediate-poor risk group, prior nephrectomy and ECOG PS <1 were predictive factors for long-term response. Some individuals with mRCC may experience a durable response to TKIs. The likelihood of a long-term response can be determined by factors such as nephrectomy, ECOG PS < 1, and the absence of brain metastases.

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