Background

The aims of this study were to investigate prognosis and validate prognostic models [Memorial Sloan-Kettering Cancer Center (MSKCC), International Metastatic Renal Cell Carcinoma Data Consortium (IMDC), and Japanese metastatic renal cancer (JMRC) models] in the targeted therapy era in Japanese patients with metastatic renal cell carcinoma.

Methods

We retrospectively analyzed 692 patients who were diagnosed with mRCC from January 2008 to August 2018 in the Michinoku Japan Urological Cancer Study Group database. Nivolumab as sequential therapy was widely used. Other immune checkpoint inhibitors were excluded from this study.

Results

The median overall survival (95% confident interval) in all, MSKCC favorable, intermediate, and poor risk patients was 41.0 months (33.9–46.8), not reached (63.5 to not estimable), 46.8 months (37.1–52.9), and 10.4 months (8.9–14.4), respectively. The median overall survival (95% confident interval) in IMDC favorable, intermediate, and poor risk patients was not reached (61.6 to not estimable), 47.4 months (41.4–56.5), and 11.5 (9.9–16.3), respectively. The c-index of the MSKCC, IMDC, and JMRC models calculated at mRCC diagnosis was 0.680, 0.689, and 0.700, respectively. No statistical differences were found in the c-index among the models.

Conclusion

While the real-world overall survival in Japanese patients with mRCC in the targeted therapy era improved compared to that previously reported in the cytokine era, there was no clear difference in the survival of poor risk patients between these eras. There were no differences in the superiority among the models.

中文翻译：

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靶向治疗时代日本转移性肾细胞癌患者的预后

背景

本研究的目的是研究靶向治疗时代的预后并验证预后模型 [纪念斯隆-凯特琳癌症中心 (MSKCC)、国际转移性肾细胞癌数据联盟 (IMDC) 和日本转移性肾癌 (JMRC) 模型]在日本转移性肾细胞癌患者中。

方法

我们回顾性分析了 2008 年 1 月至 2018 年 8 月在日本陆奥泌尿外科癌症研究组数据库中被诊断为 mRCC 的 692 名患者。Nivolumab 作为序贯疗法被广泛使用。本研究排除了其他免疫检查点抑制剂。

结果

MSKCC 良好、中等和低风险患者的中位总生存期（95% 置信区间）为 41.0 个月（33.9-46.8）、未达到（63.5 至不可估计）、46.8 个月（37.1-52.9）和 10.4月 (8.9–14.4)，分别。IMDC 良好、中度和不良风险患者的中位总生存期（95% 置信区间）分别未达到（61.6 至不可估计）、47.4 个月（41.4-56.5）和 11.5（9.9-16.3）个月。在 mRCC 诊断时计算的 MSKCC、IMDC 和 JMRC 模型的 c 指数分别为 0.680、0.689 和 0.700。模型之间的 c 指数没有发现统计学差异。

结论

虽然与之前报道的细胞因子时代相比，靶向治疗时代日本 mRCC 患者的真实总生存期有所改善，但这些时代之间低危患者的生存率没有明显差异。模型之间的优越性没有差异。