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Early tumor shrinkage is independently associated with improved overall survival among patients with metastatic renal cell carcinoma: a validation study using the COMPARZ cohort

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Abstract

Purpose

Early tumor shrinkage (eTS) has prognostic value in metastatic renal cell carcinoma (mRCC). We aimed to validate the role of eTS in first line treatment from the COMPARZ study (NCT00720941).

Methods

1100 patients treated with sunitinib or pazopanib were analyzed for tumor response according to RECIST 1.0. eTS was defined as tumor shrinkage by ≥ 10%. A landmark analysis was performed on day (d) 42 and 90 and Cox proportional hazards regression was computed for the prognostic effect of eTS.

Results

In patients with eTS median OS was 34.1 [CI 95% 28.4; not reached (NR)] and 33.6 (CI 95% 30.1; NR) months (mo) at d 42 and 90, respectively, compared to 19.6 (CI 95% 14.0; 28.9) and 15.1 (CI 95% 12.4; 18.7) mo for patients without eTS. There was no interaction between type of treatment and eTS (d 42 p = 0.79; d 90 p = 0.37). eTS ≥ 10% remained an independent prognostic marker in multivariable analyses at both d 42 and 90.

Conclusions

Similar results were found for eTS at the 42 and 90 days landmarks. eTS ≥ 10% has prognostic relevance in mRCC and reflects a putative tool to guide future clinical treatment.

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Acknowledgements

The authors thank the patients and investigators who participated in the COMPARZ trial used for this analysis.

Author information

Authors and Affiliations

  1. Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Viktor Grünwald

  2. Department of Natural Sciences, Leibniz University Hannover, Hannover, Germany

    Marion Dietrich

  3. Department of Oncology, McMaster University, Hamilton, ON, Canada

    Gregory R. Pond

Authors
  1. Viktor Grünwald
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  2. Marion Dietrich
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  3. Gregory R. Pond
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Contributions

VG had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: VG, GP. Acquisition of data: VG, MD, GP. Analysis and interpretation of data: VG, MD, GP. Drafting of the manuscript: VG. Critical revision of the manuscript for important intellectual content: VG, MD, GP. Statistical analysis: GP. Administrative, technical, or material support: Not applicable. Supervision: VG.

Corresponding author

Correspondence to Viktor Grünwald.

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Research support

The study sponsor (Novartis) shared access to the primary data of the COMPARZ study but was not involved in concept, design, conduct, or analysis of the data. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflict of interest

Viktor Grünwald has an advisory role at Pfizer, Novartis, Bristol Myer Squibb, Ipsen, Eisai, Roche and has received honoraria from Pfizer, Novartis, Bristol Myer Squibb, Ipsen, Eisai and Roche. Marion Dietrich and Gregory Pond do not have any conflict of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

345_2018_2297_MOESM1_ESM.docx

Supplementary material 1 Figure A.1: Martingale Residual Plot for percentage Shrinkage as a prognostic factor for OS A) at day 42 and B) day 90, indicating 10% as a reasonable cutpoint for tumor shrinkage at both time points. (DOCX 128 kb)

345_2018_2297_MOESM2_ESM.pptx

Supplementary material 2 Figure A.2: Consort diagram of patients included into the trial. Patients not available for response assessment at day 42 and 90 are depicted. (PPTX 37 kb)

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Grünwald, V., Dietrich, M. & Pond, G.R. Early tumor shrinkage is independently associated with improved overall survival among patients with metastatic renal cell carcinoma: a validation study using the COMPARZ cohort. World J Urol 36, 1423–1429 (2018). https://doi.org/10.1007/s00345-018-2297-4

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  • DOI: https://doi.org/10.1007/s00345-018-2297-4

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