Brain natriuretic peptide precursor (NT-pro-BNP) levels predict for clinical benefit to sunitinib treatment in patients with metastatic renal cell carcinoma
| Autor: | Christos Lafaras, Christos N. Papandreou, Charalambos Andreadis, Lukas F Kontovinis, Alexandros H. Kortsaris, Maria Christopoulou, Despoina Mouratidou, Evangelos Antonakis, George Kouvatseas, Konstantinos Papazisis |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Pathology Indoles Lung Neoplasms medicine.drug_class Antineoplastic Agents Bone Neoplasms urologic and male genital diseases lcsh:RC254-282 Tyrosine-kinase inhibitor Surgical oncology Renal cell carcinoma Internal medicine Natriuretic Peptide Brain Sunitinib Genetics medicine Natriuretic peptide Carcinoma Humans Pyrroles Carcinoma Renal Cell Aged business.industry Liver Neoplasms Middle Aged Prognosis lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Brain natriuretic peptide medicine.disease Kidney Neoplasms Peptide Fragments female genital diseases and pregnancy complications Lymphatic Metastasis Female Stem cell business Biomarkers Research Article medicine.drug |
| Zdroj: | BMC Cancer, Vol 10, Iss 1, p 489 (2010) BMC Cancer |
| ISSN: | 1471-2407 |
| Popis: | Background Sunitinib is an oral, multitargeted tyrosine kinase inhibitor that has been approved for the treatment of metastatic renal cell carcinoma. Although the majority of sunitinib-treated patients receive a clinical benefit, almost a third of the patients will not respond. Currently there is no available marker that can predict for response in these patients. Methods We estimated the plasma levels of NT-pro-BNP (the N-terminal precursor of brain natriuretic peptide) in 36 patients that were treated with sunitinib for metastatic clear-cell renal carcinoma. Results From the 36 patients, 9 had progressive disease and 27 obtained a clinical benefit (objective response or disease stabilization). Increases in plasma NT-pro-BNP were strongly correlated to clinical outcome. Patients with disease progression increased plasma BNP at statistically significant higher levels than patients that obtained a clinical benefit, and this was evident from the first 15 days of treatment (a three-fold increase in patients with progressive disease compared to stable NT-pro-BNP levels in patients with clinical benefit, p < 0.0001). Median progression-free survival was 12.0 months in patients with less than 1.5 fold increases (n = 22) and 3.9 months in patients with more than 1.5 fold increases in plasma NT-pro-BNP (n = 13) (log-rank test, p = 0.001). Conclusions This is the first time that a potential "surrogate marker" has been reported with such a clear correlation to clinical benefit at an early time of treatment. Due to the relative small number of accessed patients, this observation needs to be further addressed on larger cohorts. More analyses, including multivariate analyses are needed before such an observation can be used in clinical practice. |
| Databáze: | OpenAIRE |
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