239P - Elevated baseline C-reactive protein is a prognostic indicator for OS in patients with metastatic non clear cell renal cell carcinoma treated with systemic therapy

Background

With the induction of molecular targeted therapy and immune checkpoint inhibitors, treatment strategies for systemic treatment of metastatic clear cell renal cell carcinoma (mCCRCC) have been changed with improved survival. However, for those patients diagnosed as metastatic non-clear cell renal cell carcinoma (mNCRCC), systemic therapy designed and approved for mCCRCC have been used because no validated systemic therapy exists. This retrospective study aimed to identify prognostic factors for patients with mNCRCC treated with systemic therapy.

Methods

A total of 270 patients were reviewed. Among them, 41 patients who pathologically diagnosed as mNCRCC and received systemic therapy were retrospectively analyzed. Clinical and pathological data were retrieved and analyzed retrospectively. The progression free survival (PFS) and overall survival (OS) between mNCRCC and mCCRCC patients were compared. The OS for patients with mNCRCC was further investigated with univariate and multivariate Cox’s proportional hazards regression models.

Results

After a median follow-up of 31.3 months after first-line treatment initiation, the median PFS was 3.3 and 20.8 months for mNCRCC and mCCRCC, respectively (p<0.0001). The median OS was 19.6 and 54.4 months for mNCRCC and mCCRCC, respectively (p<0.0001). For patients with mNCRCC, univariate Cox proportional hazards model analyses revealed that the duration of first-line treatment (p<0.0001), the time to first-line treatment within 1 year (p=0.0201), high corrected serum calcium (p=0.0006), high neutrophil count (p=0.0003), and the baseline CRP level (p=0.0034) were significantly correlated with shorter OS, respectively. Furthermore, a multivariate analysis revealed the duration of first-line treatment (Hazard ratio (HR): 0.89, 95% CI: 0.81-0.97, p=0.007), the high corrected serum calcium (HR: 4.04, 95% CI: 1.58-10.37, p=0.004), and the baseline CRP level (HR: 1.15, 95% CI: 1.05-1.25, p=0.002) were independent predictors for OS in mNCRCC patients.

Conclusions

Patients with mNCCC resulted in shorter PFS and OS. Elevated baseline C-reactive protein, a prognostic factor for mCCRCC, was also correlated with shorter OS in mNCRCC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.