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Renal Cell Carcinoma pp 237–251Cite as

Predictive and Prognostic Markers in Metastatic Renal Cell Carcinoma

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Abstract

Predictive and prognostic factors enable clinicians to make informed decisions about therapy efficacy and patient survival. Despite advances in therapeutics, metastatic renal cell carcinoma (mRCC) remains largely incurable. Current standard targeted therapies (TT) for mRCC focus on inhibiting angiogenesis via the vascular endothelial growth factor (VEGF) or blocking the mammalian target of rapamycin (mTOR) pathway. The International mRCC Database Consortium (IMDC) criteria (Heng et al. J Clin Oncol 27(34):5794–5799, 2009), which focuses on patients who received targeted therapy, can be used to assess the prognosis of mRCC patients. Four of the MSKCC prognostic variables (anemia, hypercalcemia, Karnofsky performance status <80 %, and time from diagnosis to treatment of less than 1 year), as well as two additional factors (neutrophils and platelets greater than the upper limit of normal), were identified as key prognostic features. Patients were segregated into three risk categories: favorable (0 risk factors median overall survival (mOS) of 43.2 months), intermediate (one to two risk factors; mOS 22.5 months), and poor risk group (three or more risk factors; mOS 7.8 months). Also the IMDC criteria can be applied to different situations to evaluate prognosis in second-line treatment and in non-clear cell RCC (nccRCC) histologies. Benchmarks for survival have also been created for those treated with multiple lines of therapy to help guide clinical trial construction. Prognostic factors are better developed than predictive factors in mRCC but research continues in the field of biomarkers.

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Authors and Affiliations

  1. Hospital Médica Sur, Universidad Nacional Autónoma de México, México City, Mexico

    José Manuel Ruiz Morales MD

  2. Department of Oncology, Tom Baker Cancer Center, University of Calgary, 1331-29th Street NW, Calgary, AB, T2N 4N2, Canada

    Daniel Y. C. Heng MD, MPH, FRCPC

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  1. José Manuel Ruiz Morales MD
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Correspondence to Daniel Y. C. Heng MD, MPH, FRCPC .

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  1. Department of Urology, Keio University School of Medicine, Tokyo, Japan

    Mototsugu Oya

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Ruiz Morales, J.M., Heng, D.Y.C. (2017). Predictive and Prognostic Markers in Metastatic Renal Cell Carcinoma. In: Oya, M. (eds) Renal Cell Carcinoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55531-5_9

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