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Cystatin C as a predictor factor in patients with renal cell carcinoma treated by everolimus

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Abstract

Background

We evaluated the influence of serum cystatin C (CysC) with respect to other glomerular filtration rate (GFR) markers on the treatment effect of everolimus in a phase II study in patients with metastatic renal cell carcinoma (mRCC).

Materials and methods

Outcomes were from the study’s primary analysis. GFR was calculated according to CKD-EPI-sCr equation, CKD-EPI-CysC equation and CKD-EPI-sCr-CysC equation, Modification of Diet in Renal Disease (MDRD) equation and Cockcroft–Gault (CG) equation, serum levels of creatinine (sCr) and CysC before the treatment.

Results

We observed in 56 patients analysed patients high correlation (R Spearman from ±0.69 to ±1.00; P < 0.0001) between CysC level and GFR markers: sCr, CKD-EPI-sCr, CKD-EPI-CysC, CKD-EPI-sCr-CysC, MDRD, GFR (CG) before everolimus therapy. We observed that the adverse independent predictors for everolimus therapy were increased CysC level [HR: 2.85 (95 % CI 1.34–6.05), P = 0.0065], histologic grade G1/2 [HR: 3.38 (95 % CI 1.59–7.20), P = 0.0016] and increased LDH level [HR: 5.59 (95 % CI 2.52–12.40), P < 0.0001]. Worse OS was seen in multivariate analysis in patients with increased cystatin C level before treatment [HR: 2.60 (1.03–2.60), P = 0.0428], increased corrected calcium level [HR: 2.78 (95 % CI 1.03–7.54), P = 0.0441] and increased LDH level before treatment [HR: 2.34 (95 % CI 1.11–4.97), P = 0.0262].

Conclusion

Increased serum CysC level in contrast to other studied GFR markers had predictive significance in patients with mRCC.

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Funding

This study was supported by the Polish Ministry of Science and Higher Education (grant number N N402 455139).

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Authors and Affiliations

  1. Department of Oncology, Military Institute of Medicine, 128 Szaserow St., 04-141, Warsaw, Poland

    Lubomir Bodnar, Rafał Stec, Agnieszka Synowiec & Cezary Szczylik

  2. Department of Laboratory Diagnostics, Military Institute of Medicine, Warsaw, Poland

    Małgorzata Dzierżanowska

  3. Department of Pathology, Military Institute of Medicine, Warsaw, Poland

    Szczepan Cierniak

  4. Department of Nephrology, Military Institute of Medicine, Warsaw, Poland

    Grzegorz Kade

Authors
  1. Lubomir Bodnar
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  2. Rafał Stec
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  3. Małgorzata Dzierżanowska
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  4. Agnieszka Synowiec
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  5. Szczepan Cierniak
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  6. Grzegorz Kade
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  7. Cezary Szczylik
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Corresponding author

Correspondence to Lubomir Bodnar.

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Conflict of interest

The authors have declared no conflicts of interest.

Ethical approval

This study was approved by the Institutional Review Board of the Military Institute of Medicine in Warsaw (16 December 2009; No 54/WIM/2009).

Informed consent

Written informed consent was obtained from all patients.

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Bodnar, L., Stec, R., Dzierżanowska, M. et al. Cystatin C as a predictor factor in patients with renal cell carcinoma treated by everolimus. Cancer Chemother Pharmacol 78, 295–304 (2016). https://doi.org/10.1007/s00280-016-3084-9

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  • DOI: https://doi.org/10.1007/s00280-016-3084-9

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