Inverse association between baseline renal function and overall survival in patients with metastatic renal cell carcinoma who were treated with molecular-targeted agents

Background

Renal toxicity is regarded as one of the most frequently observed adverse events in metastatic renal cell carcinoma (mRCC) patients, irrespective of the type of targeted agent introduced. The objective of this study was to investigate the prognostic significance of the baseline renal function in mRCC patients treated with molecular-targeted agents.

Methods

This study included a total of 408 consecutive mRCC patients receiving molecular-targeted therapy, consisting of 124 (group A) and 284 (group B) who had baseline estimated glomerular filtration rates ≥ 60 mL/min/1.73 m² and 

Results

Compared with group A, group B was significantly less likely to have poor prognostic factors, such as a high proportion of patients without nephrectomy, unfavorable risk classified by the Memorial Sloan Kettering Cancer Center or Heng's system, high C-reactive protein level, and high incidence of lymph node, bone or liver metastasis. The median overall survivals (OSs) after the initiation of targeted therapy in groups A and B were 21.4 and 35.8 months, respectively, and there was a significant difference in the OS between these two groups; however, multivariate analysis showed the lack of independent impact of the baseline renal function on the OS. Furthermore, when patients without nephrectomy were excluded, no significant difference was noted in the OS between the two groups.

Conclusions

There appeared to be an inverse association between the baseline renal function and OS in mRCC patients receiving molecular-targeted therapy, suggesting no adverse impact of an unfavorable baseline renal function on the efficacy of targeted agents against mRCC. Accordingly, molecular-targeted therapy should not be avoided in mRCC patients with an impaired baseline renal function.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

Kobe University

Disclosure

All authors have declared no conflicts of interest.