To validate multiple prognostic models in metastatic renal cell carcinoma patients who received second-line axitinib following first-line nivolumab plus ipilimumab therapy.
Five prognostic models (ACL, albumin, C-reactive protein, and lactate dehydrogenase; IMDC, International Metastatic Renal Cell Carcinoma Database Consortium; MSKCC, Memorial Sloan Kettering Cancer Center; ATP, axitinib treatment prediction; JMRC, Japanese metastatic renal cancer) to predict overall survival (OS) were validated and compared using data from 86 metastatic renal cell carcinoma patients who received second-line axitinib therapy following first-line nivolumab plus ipilimumab therapy at 34 hospitals affiliated with the Japan Urologic Oncology Group.
The Karnofsky performance status, time from initial diagnosis to first-line therapy, and hemoglobin, platelet, albumin, and C-reactive protein levels correlated with OS in univariate Cox regression analyses. Among these factors, only albumin had a significant impact on OS in the multivariate analysis. The integrated area under the curve (AUC) of the ACL, IMDC, MSKCC, ATP, and JMRC models were 0.78, 0.76, 0.76, 0.69, and 0.70, respectively. The ACL model showed a higher value than the others in the time-dependent AUC.
The accuracy of the five prognostic models (ACL, IMDC, MSKCC, ATP, and JMRC) created in the pre-immuno-oncology (IO) treatment cohort was maintained in the second-line axitinib group after nivolumab plus ipilimumab therapy. The ACL model demonstrated moderate accuracy in predicting OS with the fewest number of clinical variables.
Japanese journal of clinical oncology. 2025 Feb 02 [Epub ahead of print]
Hiroshi Kikuchi, Takahiro Osawa, Yuto Matsushita, Takahiro Kojima, Tomokazu Sazuka, Shingo Hatakeyama, Keisuke Goto, Kazuyuki Numakura, Kazutoshi Yamana, Shuya Kandori, Kosuke Ueda, Hajime Tanaka, Toshifumi Kurahashi, Yukari Bando, Takahiro Kimura, Naotaka Nishiyama, Takuma Kato, Hiroaki Hara, Yoichi Ito, Hiroshi Kitamura, Hideaki Miyake, Nobuo Shinohara
Department of Urology, Hokkaido University Hospital, N15 W7 Kita-ku, Sapporo 060-8638, Japan., Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu 431-3192, Japan., Department of Urology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa Ward, Nagoya 464-8681, Japan., Department of Urology, Graduate School of Medicine Chiba University, 1-8-1 Inohana, chuo-ku, Chiba 260-8670, Japan., Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan., Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan., Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan., Department of Urology and Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata 951-8510, Japan., Department of Urology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan., Department of Urology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan., Department of Urology, Institute of Science Tokyo, 4-6-1 Shiroganedai, Minato-ku, Tokyo 108-8639, Japan., Department of Urology, Hyogo Prefectural Cancer Center, 13-70, KITAOJICHO, Akashi, Hyogo 673-0021, Japan., Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Kobe 650-0017, Japan., Department of Urology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi. Minato-ku, Tokyo 105-8461, Japan., Department of Urology, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan., Department of Urology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan., Department of Urology, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto 390-8621, Japan., Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo 060-8648, Japan.