Early CRP Response to mRCC Drugs Predicts Survival

Changes in C-reactive protein levels 4 weeks after starting sunitinib or sorafenib treatment are associated with overall and progression-free survival.
Changes in C-reactive protein levels 4 weeks after starting sunitinib or sorafenib treatment are associated with overall and progression-free survival.
The following article is part of conference coverage from the 2017 American Urological Association meeting in Boston. Renal and Urology News' staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from AUA 2017. 

BOSTON—Early C-reactive protein (CRP) response predicts survival among patients with metastatic renal cell carcinoma (mRCC) treated with tyrosine kinase inhibitors, Japanese investigators reported at the American Urological Association 2017 annual meeting.

Yosuke Yasuda, MD, of Tokyo Medical and Dental University, and colleagues studied 103 patients (80 men and 23 women) with mRCC treated with tyrosine kinase inhibitors (TKIs): 43 with sunitinib and 60 with sorafenib. Fifty patients (49%) had received prior immunotherapy and 69 (67%) had undergone nephrectomy. The investigators divided patients into 3 groups based on their early CRP kinetics: patients whose baseline CRP levels were below 10 mg/L (non-elevated); patients whose baseline CRP levels were 10 mg/L or higher and had declined by more than 20% 4 weeks after starting TKI therapy (early CRP responder); and the remaining patients (non-early CRP responders).

The median follow-up period was 21 months. Baseline CRP levels were elevated in 41 patients (40%). Of these 41 patients, 19 (18%) were early CRP responders. The 1-year overall survival (OS) and progression-free survival (PFS) rates for the entire cohort were 69% and 40%, respectively. The 1-year OS rates in the non-elevated group, early CRP responder group, and non-early CRP responder group were 79%, 62%, and 36%, respectively. The 1-year PFS rates for these groups were 50%, 23%, and 10%. On multivariate analysis, the early CRP kinetics assessment was a significant independent predictor of OS and PFS.

The investigators found no significant differences in objective response rates among the 3 groups, but significantly more patients in the non-early CRP responder group had progressive disease.

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Reference

Yasuda Y, Saito K, Kawamura N, et al. Early response at four weeks of C-reactive protein predicts survival in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors. [abstract] J Urol 2017;197(4S):e181. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 12, 2017. Poster MP16-06.

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