RESEARCH ARTICLE


Assessment of Predictive Biomarker in Metastatic Renal Cell Carcinoma Treated with Pazopanib



Sarayuth Boonchai1, Teeravut Tubtawee2, Worapat Attawettayanon1, *
1 Department of Surgery, Division of Urology, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand
2 Department of Radiology, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand


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Creative Commons License
© 2022 Boonchai et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Division of Urology, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand, 90110; Tel: 667-445-1401;
E-mail: aworapat@medicine.psu.ac.th


Abstract

Purpose:

Metastatic renal cell carcinoma is a heterogeneous group of neoplasms with distinctive behavior. Systemic therapy is the treatment of choice in this group of patients. It is important to identify predictive factors to predict response during treatment. In this study we retrospectively evaluate the possible responsive predictors during treatment with pazopanib in metastatic renal cell carcinoma (mRCC).

Materials and Methods:

We retrospectively reviewed 32 patients between 2012 and 2020 who were diagnosed with mRCC and received treatment with pazopanib RECIST (version 1.1) was used to evaluate tumor response and imaging data were re-evaluated by radiologists. Univariate and multivariate cox regression model was used to analyze the predictive factors with clinical outcome.

Results:

Male patient was predominated (65.6%) and most of the patients had prior nephrectomy (71.9%). During treatment 32 (72%) patients experienced elevated liver enzymes and 16 (50%) had diarrhea. Overall response rate and disease control rate were 21.88% and 68.75% respectively. Hemoglobin ≤ 11 g/dl (p=0.001) and NLR ≥ 3.5 (p=0.02) were associated with poor response. Multivariate analysis show increasing age (p=0.008) and level of NLR (p=0.037) were independent factors associated with the response of treatment.

Conclusion:

Increasing age could be a positive predictor of the disease control response of patients with mRCC while leveling NLR ≥ 3.5 represented a poor outcome of treatment with pazopanib.

Keywords: Renal cell carcinoma, Pazopanib, Prognostic marker, Biomarker, Univariate, mRCC.