In this study, the authors aimed to develop a new prognostic model which can predict early death in patients with metastatic RCC receiving first-line TKI. This was a retrospective case series study, examining 498 patients with metastatic RCC receiving first-line TKI from 2007 to 2016. The primary endpoint was the mortality rate within one year after TKI treatment.
The results demonstrated an overall mortality rate of 59% and an early mortality rate of 19.7%. Overall survival of the metastatic RCC patients with TKI is shown in figure 1.
Figure 1:
The C-index of the IMDC model for early death was 0.667. Five variables were selected: previous nephrectomy, BMI, multiple metastases, previous metastasectomy, and serum albumin level. The C-index of model 1, which includes five new variables plus variables in the IDMC model, is 0.809, showing a significant improvement over the IDMC model. In model 2, hemoglobin and neutrophil levels were added in new five variables, and the C-index was 0.821. Figure 2 demonstrates a comparison of the diagnostic accuracy between models for predicting early death less than a year after 1st line TKI in metastatic RCC patients by using ROC curve analysis.
Figure 2 :
In conclusion, these novel models can improve predictive power for early death in metastatic RCC patients, better than the IMDC model.
Presented by: Minyong Kang, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2019 American Society of Clinical Oncology Genitourinary Cancers Symposium, (ASCO GU) #GU19, February 14-16, 2019 - San Francisco, CA