A novel prognostic model was recommended for patients with metastatic RCC (mRCC) by the International mRCC Database Consortium (IMDC). In this study, we aimed to externally validate a novel risk model for the IMDC-favorable risk group in patients with mRCC.
The Turkish Oncology Group Kidney Cancer Consortium (TKCC) is a multicenter registry that includes 13 cancer centers in Turkey. As described by Schmidt et al., 3 parameters (ie, time from diagnosis to systemic therapy <3 vs. ≥3 years, Karnofsky Performance Status [KPS] 80 vs. >80, and the presence of brain, liver, or bone metastasis) were used to divide the IMDC favorable risk group into 2 new categories: very favorable and favorable risk groups. The primary endpoint was overall survival (OS). Time to treatment failure (TTF) and objective response rate (ORR) in the very favorable and favorable risk groups were the secondary endpoints.
A total of 545 patients with mRCC from all IMDC risk groups and 112 patients from the favorable risk group were included in this study. According to the novel classification model, 44 (39.3%) and 68 (60.7%) patients with former favorable risk were categorized into very favorable and favorable risk groups, respectively. The median OS (55.8 months vs. 34.2 months, P = .025) and TTF (25.5 months vs. 15.5 months, P = .010) were longer in the very favorable risk group than in the favorable risk group. The concordance index of the new IMDC model in all patients was 0.65 for OS. Despite the higher ORR in the very favorable risk group than in the favorable risk group, the difference between the groups was not statistically significant (52.4% vs. 44.7, P = .573).
This was the first study to externally validate the novel IMDC risk model presented in the American Society of Clinical Oncology Genitourinary Cancers Symposium 2021.
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- Targeted therapies for the treatment of metastatic renal cell carcinoma: clinical evidence.Oncologist. 2011; 16: 14-22
- Sunitinib for the treatment of metastatic renal cell carcinoma.Cancer Treat Rev. 2011; 37: 178-184
- First-line treatment of metastatic renal cell carcinoma after COMPARZ and PISCES.Curr Opin Urol. 2015; 25: 395-401
- Immunotherapy is changing first-line treatment of metastatic renal-cell carcinoma.Clin Genitourin Cancer. 2019; 17: e513-e521
- Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study.J Clin Oncol. 2009; 27: 5794-5799
- External validation and comparison with other models of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model: a population-based study.Lancet Oncol. 2013; 14: 141-148
- Efficacy of nivolumab plus ipilimumab according to number of IMDC risk factors in CheckMate 214.Eur Urol. 2020; 77: 449-453
- Active surveillance in metastatic renal-cell carcinoma: a prospective, phase 2 trial.Lancet Oncol. 2016; 17: 1317-1324
- The very favorable metastatic renal cell carcinoma (mRCC) risk group: data from the International Metastatic RCC Database Consortium (IMDC).J Clin Oncol. 2021; 39 (339-339)
- Treatment of renal cell carcinoma: current status and future directions.CA Cancer J Clin. 2017; 67: 507-524
- Pembrolizumab plus axitinib versus sunitinib monotherapy as first-line treatment of advanced renal cell carcinoma (KEYNOTE-426): extended follow-up from a randomised, open-label, phase 3 trial.Lancet Oncol. 2020; 21: 1563-1573
- Atezolizumab plus bevacizumab versus sunitinib in patients with previously untreated metastatic renal cell carcinoma (IMmotion151): a multicentre, open-label, phase 3, randomised controlled trial.Lancet. 2019; 393: 2404-2415
- Avelumab plus axitinib versus sunitinib for advanced renal-cell carcinoma.N Engl J Med. 2019; 380: 1103-1115
- Lenvatinib plus pembrolizumab or everolimus for advanced renal cell carcinoma.N Engl J Med. 2021; 384: 1289-1300
- Nivolumab plus cabozantinib versus sunitinib for advanced renal-cell carcinoma.N Engl J Med. 2021; 384: 829-841
- Is there a preferred first-line therapy for metastatic renal cell carcinoma? A network meta-analysis.Ther Adv Urol. 2021; 1317562872211053189
Published online: July 14, 2022
Accepted: July 9, 2022
Received in revised form: June 30, 2022
Received: April 18, 2022
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