Active smoking may negatively affect response rate, progression-free survival, and overall survival of patients with metastatic renal cell carcinoma treated with sunitinib
| Autor: | Michael A. Carducci, Maya Ish-Shalom, Rony Weitzen, Roberto Pili, Daniel Keizman, Natalie Maimon, Maya Gottfried, Avivit Neumann, Hans J. Hammers, Avivit Peer, Ben Boursi, Wilmosh Mermershtain, Henry Hayat, Mario A. Eisenberger, Victoria J. Sinibaldi, Keren Rouvinov, Raanan Berger, Avishay Sella, Svetlana Kovel |
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| Rok vydání: | 2013 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Indoles Antineoplastic Agents urologic and male genital diseases Young Adult Genitourinary Cancer: Renal Bladder and Testicular Renal cell carcinoma Risk Factors Diabetes mellitus Internal medicine medicine Sunitinib Humans Multicenter Studies as Topic Pyrroles Progression-free survival Young adult Neoplasm Metastasis Carcinoma Renal Cell Aged Randomized Controlled Trials as Topic Retrospective Studies Response rate (survey) Aged 80 and over business.industry Smoking Retrospective cohort study Middle Aged medicine.disease Obesity female genital diseases and pregnancy complications Kidney Neoplasms Treatment Outcome Multivariate Analysis Female business medicine.drug |
| Zdroj: | The oncologist. 19(1) |
| ISSN: | 1549-490X |
| Popis: | Obesity, smoking, hypertension, and diabetes are risk factors for renal cell carcinoma development. Their presence has been associated with a worse outcome in various cancers. We sought to determine their association with outcome of sunitinib treatment in metastatic renal cell carcinoma (mRCC).An international multicenter retrospective study of sunitinib-treated mRCC patients was performed. Multivariate analyses were performed to determine the association between outcome and the pretreatment status of smoking, body mass index, hypertension, diabetes, and other known prognostic factors.Between 2004 and 2013, 278 mRCC patients were treated with sunitinib: 59 were active smokers, 67 were obese, 73 were diabetic, and 165 had pretreatment hypertension. Median progression-free survival (PFS) was 9 months, and overall survival (OS) was 22 months. Factors associated with PFS were smoking status (past and active smokers: hazard ratio [HR]: 1.17, p = .39; never smokers: HR: 2.94, p.0001), non-clear cell histology (HR: 1.62, p = .011), pretreatment neutrophil-to-lymphocyte ratio3 (HR: 3.51, p.0001), use of angiotensin system inhibitors (HR: 0.63, p = .01), sunitinib dose reduction or treatment interruption (HR: 0.72, p = .045), and Heng risk (good and intermediate risk: HR: 1.07, p = .77; poor risk: HR: 1.87, p = .046). Factors associated with OS were smoking status (past and active smokers: HR: 1.25, p = .29; never smokers: HR: 2.7, p.0001), pretreatment neutrophil-to-lymphocyte ratio3 (HR: 2.95, p.0001), and sunitinib-induced hypertension (HR: 0.57, p = .002).Active smoking may negatively affect the PFS and OS of sunitinib-treated mRCC. Clinicians should consider advising patients to quit smoking at initiation of sunitinib treatment for mRCC. |
| Databáze: | OpenAIRE |
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