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. 2019 May 23;9(1):7754.
doi: 10.1038/s41598-019-44226-y.

Metastatic Tumor Burden and Loci as Predictors of First Line Sunitinib Treatment Efficacy in Patients with Renal Cell Carcinoma

Anna M Czarnecka  1 , Anna Brodziak  2   3   4 , Pawel Sobczuk  2   3   4 , Cezary Dendek  5   6 , Dominika Labochka  2   7 , Jan Korniluk  2 , Ewa Bartnik  8   9 , Cezary Szczylik  2   10   11
Affiliations

Metastatic Tumor Burden and Loci as Predictors of First Line Sunitinib Treatment Efficacy in Patients with Renal Cell Carcinoma

Anna M Czarnecka et al. Sci Rep. .

Abstract

The aim of this study was to investigate the prognostic impact of baseline tumor burden and loci on the efficacy of first line renal cancer treatment with sunitinib. Baseline and on-treatment CT scans were evaluated. Both the Kaplan-Meier and Weibull modelling survival estimators have been used to describe sunitinib treatment response. Logistic regression was used to confirm associations between tumor site, burden and survival. Additionally, analysis of the metastases co-occurrence was conducted using the Bayesian inference on treated and external validation cohorts. 100 patients with metastatic clear cell renal cell carcinoma were treated with sunitinib in this study. Presence of metastases in the abdominal region (HR = 3.93), and the number of brain metastases correlate with shorter PFS, while the presence of thoracic metastases (HR = 0.47) with longer PFS. Localization of metastases in the abdominal region significantly impacts risk of metastases development in other locations including bone and brain metastases. Biology of metastases, in particular their localization, requires further molecular and clinical investigation.

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Conflict of interest statement

A.M.C., C.S. and J.K. received lecture, travel and accommodations expenses from Pfizer, GSK and Novartis.

Figures

Figure 1
Figure 1
Estimated changes in proportion between sexes vs the age at nephrectomy.
Figure 2
Figure 2
Waterfall plot of the best overall response to sunitinib.
Figure 3
Figure 3
(a) Kaplan-Meier estimator of the Progression-Free Survival; (b) Comparison of the Kaplan-Meier and Weibull estimates of Progression-Free Survival; (c) The density of the bootstrapped Kaplan-Meier median survival estimator; (d) The density of the bootstrapped Weibull median survival estimator.
Figure 4
Figure 4
(a) Kaplan-Meier estimator of the Overall Survival; (b) Comparison of the Kaplan-Meier and Weibull estimates of Overall Survival; (c) The density of the bootstrapped Kaplan-Meier median OS estimator; (d) The density of the bootstrapped Weibull median OS estimator.
Figure 5
Figure 5
The mosaic plot of metastases co-occurrence frequency among the patients with abdominal metastases.
Figure 6
Figure 6
The mosaic plot of metastases co-occurrence frequency among the patients with bone metastases.
Figure 7
Figure 7
The mosaic plot of metastases co-occurrence frequency among the patients with thoracic metastases.
Figure 8
Figure 8
The mosaic plot of metastases co-occurrence frequency among the patients with brain metastases.
See this image and copyright information in PMC

References

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