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Prognostic factors of response or failure of treatment in patients with metastatic renal carcinomas treated by cytokines: a report from the Groupe Français d’Immunothérapie

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Abstract

Interleukin-2 (IL2) or/and interferon (IFN) are routinely used for treating patients with metastatic renal cell cancer. However, results are disappointing since most patients experience treatment failure. Within 6 years, the Groupe Français d’Immunothérapie enrolled 782 patients in successive multicenter trials using cytokine regimens. Univariate and multivariate analyses were performed on this large prospective database to identify prognostic factors for treatment response or failure. We identified two independent factors predictive of response to cytokine treatment: having only one metastatic organ site and receiving a combination of cytokine treatments. We also identified four independent factors predictive of rapid progression under treatment: presence of hepatic metastases, short interval from renal tumor to metastases (<1 year), more than one metastatic site and elevated neutrophil counts. Patients who combine at least three of these factors have over 80% probability of rapid progression despite treatment. We think that these results must be taken into account for cytokine treatment decision.

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References

  1. Blay JY, Négrier S, Combaret V et al. (1992) Serum level of interleukin 6 as a prognosis factor in metastatic renal cell carcinoma. Cancer Res 52:3317–3322

    Google Scholar 

  2. Bukowski RM (1997) Natural history and therapy of metastatic renal cell carcinoma: the role of interleukin-2. Cancer 80:1198–1220

    Article  Google Scholar 

  3. Childs R, Chernoff A, Contentin N et al. (2000) Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med 343:750–758

    Article  CAS  PubMed  Google Scholar 

  4. De Forges A, Rey A, Klink M et al. (1988) Prognostic factors of adult metastatic renal carcinoma: a multivariate analysis. Sem Surg Oncol 4:149–154

    Google Scholar 

  5. Elson PJ, Witte RS, Trump DL (1988) Prognostic factors for survival in patients with recurrent or metastatic renal cell carcinoma. Cancer Res 48:7310–7313

    Google Scholar 

  6. Fossa SD, Kramar A, Droz JP (1994) Prognostic factors and survival in patients with metastatic renal cell carcinoma treated with chemotherapy or interferon-alpha. Eur J Cancer 30:1310–1314

    Google Scholar 

  7. Gold PJ, Thompson JA, Markowitz DR et al. (1997) Metastatic renal cell carcinoma: long-term survival after therapy with high-dose continuous-infusion interleukin-2. Cancer J Sci Am 3:S85-S91

    Google Scholar 

  8. Ljungberg B, Grankvist K, Rasmuson T (1997) Serum interleukin-6 in relation to acute-phase reactants and survival in patients with renal cell carcinoma. Eur J Cancer 33:1794–1798

    Google Scholar 

  9. Lopez Hänninen E, Kirchner H, Atzpodien J (1996) Interleukin-2 based home therapy of metastatic renal cell carcinoma: risks and benefits in 215 consecutive single institution patients. J Urol 155:19–25

    PubMed  Google Scholar 

  10. Motzer RJ, Bander NH, Nanus DM (1996) Renal-cell carcinoma. N Engl J Med 335:865–875

    Article  CAS  PubMed  Google Scholar 

  11. Motzer RJ, Mazumdar M, Bacik J et al. (1999) Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol 17:2530–2540

    CAS  PubMed  Google Scholar 

  12. Motzer RJ, Mazumdar M, Bacik J et al. (2000) Effect of cytokine therapy on survival for patients with advanced renal cell carcinoma. J Clin Oncol 18:1928–1935

    Google Scholar 

  13. Négrier S, Caty A, Lesimple T et al. (2000) Treatment of patients with metastatic renal cell carcinoma with a combination of subcutaneous interleukin-2 and interferon alfa with or without fluorouracil. J Clin Oncol 18:4009–4015

    CAS  PubMed  Google Scholar 

  14. Négrier S, Escudier B, Gomez F et al. (2002) Prognostic factors of survival and rapid progression in 782 patients with metastatic renal carcinomas treated by cytokines: a report from the Groupe Français d’Immunothérapie. Ann Oncol 13:1460–1468

    Google Scholar 

  15. Négrier S, Escudier B, Lasset C et al. (1998) Recombinant human interleukin-2, recombinant human interferon alfa-2a, or both in metastatic renal-cell carcinoma. N Engl J Med 338:1272–1278

    Article  CAS  PubMed  Google Scholar 

  16. Palmer PA, Vinke J, Philip T, Négrier S et al. (1992) Prognostic factors for survival in patients with advanced renal cell carcinoma treated with recombinant interleukin-2. Ann Oncol 3:475–480

    Google Scholar 

  17. Ravaud A, Audhuy B, Gomez B et al. (1998) Subcutaneous interleukin-2, interferon alfa-2a, and continuous infusion of fluorouracil in metastatic renal cell carcinoma: a multicenter phase II trial. Groupe Francais d’Immunotherapie. J Clin Oncol 16:2728–2732

    Google Scholar 

  18. Ravaud A, Delva R, Gomez F et al. (2002) Subcutaneous interleukin-2 and interferon alpha in the treatment of patients with metastatic renal cell carcinoma-Less efficacy compared with intravenous interleukin-2 and interferon alpha. Results of a multicenter phase II trial from the Groupe Francais d’Immunotherapie. Cancer 95:2324–2330

    Google Scholar 

  19. Rini BI, Vogelzang NJ, Dumas MC et al. (2000) Phase II trial of weekly intravenous gemcitabine with continuous infusion fluorouracil in patients with metastatic renal cell cancer. J Clin Oncol 18:2419–2426

    Google Scholar 

  20. Yagoda A, Abi-Rached B, Petrylak D (1995) Chemotherapy for advanced renal-cell carcinoma: 1983–1993. Semin Oncol 22:42–60

    CAS  Google Scholar 

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Acknowledgments

We thank M.D. Reynaud for editorial assistance. Groupe Français d’Immunothérapie investigators: Armelle Caty, Centre Oscar Lambret, 59020 Lille; Bruno Coudert, Pierre Fargeot, Centre Georges Francois Leclerc, 21034 Dijon; Stéphane Culine, Michel Fabbro, Centre Val D’aurelle, 34094 Montpellier; Rémy Delva, Centre Paul Papin, 49036 Angers; Lionel Geoffrois, Centre Alexis Vautrin, 54511 Vandoeuvre-Les-Nancy; Thierry Lesimple, Centre Eugene Marquis, 35062 Rennes; Jean Peny, Centre Francois Baclesse, 14021 Caen; Patrice Viens, Institut Paoli-Calmettes, 13273 Marseille; Bruno Audhuy, F. Khoser, Hopital Louis Pasteur, 68021 Colmar; Jaafar Benouna, Centre Rene Gauducheau, 44035 St-Herblain; Michel Bittard, C.H.R.U. Hopital St-Jacques, 25030 Besancon; Olivier Boulat, Hopital Henri Duffaut, 84025 Avignon; Thierry Dorval, Institut Curie, 75231 Paris; Jean-Christophe Eymard, Institut Jean Godinot, 51056 Reims; Jean-Marc Ferrero, Antoine Thyss, Centre Antoine Lacassagne, 06189 Nice; Joël Fleury, Centre Jean Perrin, 63011 Clermont-Ferrand; Alain Goupil, Centre Rene Huguenin, 92211 St-Cloud; Eric Legouffe, Jean-François ROSSI, C.H.R.U. Lapeyronie, 34094 Montpellier; Claude Linassier, C.H.U. Tours, 37044 Tours; Yacine Merrouche, C.H.R.U. Minjoz, 25030 Besancon; Laurent Mignot, Hopital Foch, 92151 Suresnes; Mireille Mousseau, C.H.R.U. Michallon, 38023 Grenoble; Xavier Murraciole, C.H.R.U. La Timone, 13385 Marseille; Hubert Orfeuvre, Hopital Fleyriat, 01012 Bourg En Bresse.

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Correspondence to Sylvie Negrier.

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Negrier, S., Gomez, F., Douillard, JY. et al. Prognostic factors of response or failure of treatment in patients with metastatic renal carcinomas treated by cytokines: a report from the Groupe Français d’Immunothérapie. World J Urol 23, 161–165 (2005). https://doi.org/10.1007/s00345-004-0467-z

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