World Journal of Urology

, Volume 36, Issue 9, pp 1423–1429 | Cite as

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

  • Viktor Grünwald
  • Marion Dietrich
  • Gregory R. Pond
Original Article



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).


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.


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.


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.


Early tumor shrinkage Overall survival Predictive factor Prognostic factor Progression-free survival Metastatic renal cell carcinoma 



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

Author 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.

Compliance with ethical standards

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.

Supplementary material

345_2018_2297_MOESM1_ESM.docx (129 kb)
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 (38 kb)
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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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Hematology, Hemostasis, Oncology, and Stem Cell TransplantationHannover Medical SchoolHannoverGermany
  2. 2.Department of Natural SciencesLeibniz University HannoverHannoverGermany
  3. 3.Department of OncologyMcMaster UniversityHamiltonCanada

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