Validation of the IMDC Prognostic Model in Patients With Metastatic Renal-Cell Carcinoma Treated With First-Line Axitinib: A Multicenter Retrospective Study

• Published in: Clinical genitourinary cancer Vol. 17; no. 5; pp. e1080 - e1089
• Main Authors: Konishi, Sakae, Hatakeyama, Shingo, Numakura, Kazuyuki, Narita, Shintaro, Inoue, Takamitsu, Saito, Mitsuru, Tokui, Noriko, Yamamoto, Hayato, Yoneyama, Takahiro, Hashimoto, Yasuhiro, Yoshikawa, Kazuaki, Narita, Satoshi, Kawaguchi, Toshiaki, Habuchi, Tomonori, Ohyama, Chikara
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2019
• Subjects: Aged; Antineoplastic Agents - therapeutic use; Axitinib - therapeutic use; Carcinoma, Renal Cell - drug therapy; Databases, Factual; Female; Heterogeneity; Humans; Kidney Neoplasms - drug therapy; Male; Metastasis; Middle Aged; Models, Theoretical; Molecular Targeted Therapy; Prognosis; Prognostic model; Renal-cell carcinoma; Retrospective Studies; Risk criteria; Heterogeneity; Prognostic model; Metastasis; Renal-cell carcinoma; Risk criteria
• ISSN: 1558-7673; 1938-0682
• DOI: 10.1016/j.clgc.2019.07.006

The objective of the study was to validate the characteristics of the International Metastatic Renal-Cell Carcinoma Database Consortium (IMDC) prognostic model in patients treated with first-line axitinib in clinical practice.
We retrospectively evaluated 143 patients with metastatic renal-cell carcinoma who were treated with axitinib as the first-line therapy between October 2008 and February 2019. Overall survival (OS) was evaluated according to the IMDC prognostic model. We investigated the intragroup heterogeneity in the intermediate-risk group and divided these patients according to abnormal C-reactive protein (CRP) levels. An inverse probability of treatment-weighted (IPTW)-adjusted Cox regression analysis was performed to evaluate the effects of the CRP-risk model of OS in the patients in the IMDC intermediate-risk group.
A significant difference in OS was observed in patients in the IMDC intermediate- and poor-risk group, although no significant difference was observed between the IMDC favorable- and intermediate-risk group. Significantly shorter prognosis was observed in patients in the IMDC intermediate-risk group who had 2 risk factors and CRP ≥0.3 mg/dL (inter-high group) than in those with 1 risk factor or 2 risk factors with CRP <0.3 mg/dL (inter-low group). IPTW-adjusted Cox regression analysis revealed significant differences in the OS between the inter-low and inter-high groups.
The IMDC prognostic model was active in patients who received first-line axitinib treatment. The combination of CRP value with the number of positive risk factors in the IMDC model might predict prognosis in patients with IMDC intermediate-risk treated with first-line axitinib.
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We validated the characteristics of the International Metastatic Renal-Cell Carcinoma Database Consortium (IMDC) prognostic model in patients with metastatic renal-cell carcinoma treated with axitinib in the first-line setting. The IMDC prognostic model was active in patients who received axitinib in the first-line setting. The combination of C-reactive protein value with the number of positive risk factors might predict prognosis in patients in the IMDC intermediate-risk group.