Advertisement

External Validation of a Novel Risk Model in Patients With Favorable Risk Renal Cell Carcinoma Defined by International Metastatic Renal Cell Carcinoma Database Consortium (IMDC): Results From the Turkish Oncology Group Kidney Cancer Consortium (TKCC) Database

      Abstract

      Background

      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.

      Methods

      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.

      Results

      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).

      Conclusions

      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.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Genitourinary Cancer
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hutson TE.
        Targeted therapies for the treatment of metastatic renal cell carcinoma: clinical evidence.
        Oncologist. 2011; 16: 14-22
        • Oudard S
        • Beuselinck B
        • Decoene J
        • Albers P.
        Sunitinib for the treatment of metastatic renal cell carcinoma.
        Cancer Treat Rev. 2011; 37: 178-184
        • Schmidinger M
        • Wittes J.
        First-line treatment of metastatic renal cell carcinoma after COMPARZ and PISCES.
        Curr Opin Urol. 2015; 25: 395-401
        • Labriola MK
        • Batich KA
        • Zhu J
        • et al.
        Immunotherapy is changing first-line treatment of metastatic renal-cell carcinoma.
        Clin Genitourin Cancer. 2019; 17: e513-e521
        • Heng DY
        • Xie W
        • Regan MM
        • et al.
        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
        • Heng DY
        • Xie W
        • Regan MM
        • et al.
        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
        • Escudier B
        • Motzer RJ
        • Tannir NM
        • et al.
        Efficacy of nivolumab plus ipilimumab according to number of IMDC risk factors in CheckMate 214.
        Eur Urol. 2020; 77: 449-453
        • Rini BI
        • Dorff TB
        • Elson P
        • et al.
        Active surveillance in metastatic renal-cell carcinoma: a prospective, phase 2 trial.
        Lancet Oncol. 2016; 17: 1317-1324
        • Schmidt AL
        • Xie W
        • Gan CL
        • et al.
        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)
        • Barata PC
        • Rini BI.
        Treatment of renal cell carcinoma: current status and future directions.
        CA Cancer J Clin. 2017; 67: 507-524
        • Powles T
        • Plimack ER
        • Soulières D
        • et al.
        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
        • Rini BI
        • Powles T
        • Atkins MB
        • et al.
        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
        • Motzer RJ
        • Penkov K
        • Haanen J
        • et al.
        Avelumab plus axitinib versus sunitinib for advanced renal-cell carcinoma.
        N Engl J Med. 2019; 380: 1103-1115
        • Motzer R
        • Alekseev B
        • Rha SY
        • et al.
        Lenvatinib plus pembrolizumab or everolimus for advanced renal cell carcinoma.
        N Engl J Med. 2021; 384: 1289-1300
        • Choueiri TK
        • Powles T
        • Burotto M
        • et al.
        Nivolumab plus cabozantinib versus sunitinib for advanced renal-cell carcinoma.
        N Engl J Med. 2021; 384: 829-841
        • Cattrini C
        • Messina C
        • Airoldi C
        • et al.
        Is there a preferred first-line therapy for metastatic renal cell carcinoma? A network meta-analysis.
        Ther Adv Urol. 2021; 1317562872211053189