Impact of Immune Parameters on Long-Term Survival in Metastatic Renal Cell Carcinoma
- 1 May 2006
- journal article
- genitourinary cancer
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 24 (13), 1997-2005
- https://doi.org/10.1200/jco.2005.03.9594
Abstract
Purpose: The purpose of this study was to evaluate the impact of immunologic prognostic factors in combination with established clinical prognostic factors in patients with metastatic renal cell carcinoma (mRCC). Patients and Methods: A total of 120 consecutive patients with mRCC received interleukin-2 (IL-2) -based immunotherapy. Baseline tumor biopsies were available from 85 of these patients. Potential prognostic factors were analyzed by univariate and multivariate analyses. Results: Multivariate analysis (N = 120) identified high lactate dehydrogenase, lymph node metastases, low hemoglobin, low Karnofsky performance status, and bone metastases as independent poor prognostic clinical factors. The impact of these clinical factors has been demonstrated by others. Multivariate analysis (n = 85) also identified a high blood neutrophil count (> 6.0 × 109/L; hazard ratio, 2.0; P = .015), the presence of intratumoral neutrophils (> 0 cells/mm2 tumor tissue; hazard ratio, 2.3; P = .001), and low intratumoral CD57+ natural killer cell count (< 50 cells/mm2 tumor tissue; hazard ratio, 2.1; P = .01) as independent poor prognostic immunologic factors. These three independent immunologic parameters had significant discriminatory power as supplemental risk factors in prognostic models based on the clinical risk factors, identifying subgroups within the favorable clinical group with estimated 5-year survival rates of 60%, 25%, and 0%, respectively. These findings were apparent in both our own prognostic model and in an extended Memorial Sloan-Kettering Cancer Center (New York, NY) prognostic model. Conclusion: This study points on five clinical and three supplemental immunologic independent prognostic factors of survival in patients with mRCC receiving IL-2.Keywords
This publication has 42 references indexed in Scilit:
- Global Cancer Statistics, 2002CA: A Cancer Journal for Clinicians, 2005
- Prognostic factors of survival and rapid progression in782 patients with metastatic renal carcinomas treated by cytokines: a report from the Groupe Français d’ImmunothérapieAnnals Of Oncology, 2002
- Thirteen‐year, long‐term efficacy of interferon 2α and interleukin 2‐based home therapy in patients with advanced renal cell carcinomaCancer, 2002
- Five-Year Survival Results of Subcutaneous Low-Dose Immunotherapy with Interleukin-2 Alone in Metastatic Renal Cell Cancer PatientsUrologia Internationalis, 2000
- SYSTEMIC THERAPY FOR RENAL CELL CARCINOMAJournal of Urology, 2000
- Survival and Prognostic Stratification of 670 Patients With Advanced Renal Cell CarcinomaJournal of Clinical Oncology, 1999
- Natural history and therapy of metastatic renal cell carcinomaCancer, 1997
- The Impact of Interleukin-2 on Survival in Renal Cancer: A Multivariate AnalysisCancer Biotherapy, 1993
- Prognostic factors for survival in patients with advanced renal cell carcinoma treated with recombinant interleukin-2Annals Of Oncology, 1992
- Renal Cell Carcinoma: Natural History and Results of TreatmentJournal of Urology, 1978