Factors Prognostic for Survival in Japanese Patients Treated with Sunitinib as First-line Therapy for Metastatic Clear Cell Renal Cell Cancer

Background: Factors predictive of survival have been identified in Western patients with metastatic clearcell renal cell carcinoma (mCCRCC) treated with sunitinib. Less is known, however, about factors predictiveof survival in Japanese patients. This study evaluated factors prognostic of survival in Japanese patients withmCCRCC treated with first-line sunitinib. Materials and
Methods: This retrospective study evaluated 46consecutive Japanese mCCRCC patients treated with sunitinib as first line therapy. Clinical and biochemicalmarkers associated with progression-free survival (PFS) were analyzed, with prognostic factors selected by uniandmultivariate Cox regression analyses.
Results: Univariate analysis showed that factors significantly associatedwith poor PFS included Memorial Sloan-Kettering Cancer Center poor risk scores, International MetastaticRCC Database Consortium poor risk and high (>0.5 mg/dl) serum C-reactive protein (CRP) concentrations(p<0.001 each). Multivariate analysis showed that high serum CRP was independently associated with poorerPFS (p=0.040). Six month disease control rate (complete response, partial response and stable disease) in responseto sunitinib was significantly higher in patients with normal (≤0.5 mg/dl) than elevated baseline CRP (p<0.001).
Conclusions: CRP is a significant independent predictor of PFS for Japanese patients with mCCRCC treatedwith first-line sunitinib. Pretreatment CRP concentration may be a useful biomarker predicting response tosunitinib treatment.