Prognosis of metastatic renal cell carcinoma with first-line interferon-α therapy in the era of molecular-targeted therapy.
Prognosis of metastatic renal cell carcinoma with first-line interferon-α therapy in the era of molecular-targeted therapy.
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DOI：
10.1111/cas.12951
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发表时间：
2016-07
期刊：
影响因子：
5.7
通讯作者：
Naito S
中科院分区：
文献类型：
--
作者：
Kawano Y;Takahashi W;Eto M;Kamba T;Miyake H;Fujisawa M;Kamai T;Uemura H;Tsukamoto T;Azuma H;Matsubara A;Nishimura K;Nakamura T;Ogawa O;Naito S
RCC‐SELECT研究显示STAT3基因单核苷酸多态性（SNP）与使用一线干扰素α （IFN‐α）治疗的转移性肾癌（mRCC）患者的生存存在相关性。在该研究中，即使是与较短总生存期（OS）相关的STAT3 SNP患者也表现出显著改善的预后。进一步分析上述研究中评估的所有180例患者的OS与人口统计学/临床病理参数之间的相关性。使用Kaplan-Meier法估计OS。使用log‐rank检验和Cox比例风险模型评估OS与潜在预后因素之间的关联。中位OS为42.8个月。单因素分析显示，较差的东部肿瘤合作组表现状态（ECOG‐PS）、高T期、区域淋巴结转移、远处转移、较高的分级、浸润性生长模式、存在显微血管侵犯（MVI）、高钙血症、贫血、血小板减少症和C反应蛋白升高与OS显著相关。多因素分析显示，ECOG‐PS（危险比[HR] = 3.665, P = 0.0004）、高钙血症（危险比[HR] = 6.428, P = 0.0005）和MVI的存在（危险比[HR] = 2.668, P = 0.0109）共同为不良预后的显著因素。这是第一个使用大队列前瞻性研究分析一线IFN - α mRCC患者预后因素的研究。目前的研究表明，即使在分子靶向治疗时代，一线IFN α仍然是mRCC的有效治疗方法。
The RCC‐SELECT study showed the correlation between single nucleotide polymorphisms (SNP) in STAT3 gene and survival in metastatic renal cell carcinoma (mRCC) patients with first‐line interferon‐α (IFN‐α). In that study, even patients with STAT3 SNP linked to shorter overall survival (OS) exhibited remarkably improved prognosis. All 180 patients evaluated in the above study were further analyzed for correlation between OS and demographics/clinicopathological parameters. OS was estimated using the Kaplan–Meier method. Associations between OS and potential prognostic factors were assessed using the log‐rank test and the Cox proportional hazards model. The median OS was 42.8 months. Univariate analysis showed that worse Eastern Cooperative Oncology Group‐performance status (ECOG‐PS), high T stage, regional lymph node metastasis, distant metastasis, higher grade, infiltrative growth pattern, the presence of microscopic vascular invasion (MVI), hypercalcemia, anemia, thrombocytopenia and elevated C‐reactive protein were significantly associated with OS. Multivariate analysis revealed that ECOG‐PS (hazard ratio [HR] = 3.665, P = 0.0004), hypercalcemia (HR = 6.428, P = 0.0005) and the presence of MVI (HR = 2.668, P = 0.0109) were jointly significant poor prognostic factors. This is the first study analysing prognostic factors of mRCC patients with first‐line IFN‐α using large cohort of the prospective study. The present study suggests that first‐line IFN‐α is still a useful therapy for mRCC even in the era of molecular targeted therapy.