Validation of the IMDC Prognostic Model in Patients With Metastatic Renal-Cell Carcinoma Treated With First-Line Axitinib: A Multicenter Retrospective Study.

The objective of the study was to validate the characteristics of the International Metastatic Renal-Cell Carcinoma Database Consortium (IMDC) prognostic model in patients treated with first-line axitinib in clinical practice.

We retrospectively evaluated 143 patients with metastatic renal-cell carcinoma who were treated with axitinib as the first-line therapy between October 2008 and February 2019. Overall survival (OS) was evaluated according to the IMDC prognostic model. We investigated the intragroup heterogeneity in the intermediate-risk group and divided these patients according to abnormal C-reactive protein (CRP) levels. An inverse probability of treatment-weighted (IPTW)-adjusted Cox regression analysis was performed to evaluate the effects of the CRP-risk model of OS in the patients in the IMDC intermediate-risk group.

A significant difference in OS was observed in patients in the IMDC intermediate- and poor-risk group, although no significant difference was observed between the IMDC favorable- and intermediate-risk group. Significantly shorter prognosis was observed in patients in the IMDC intermediate-risk group who had 2 risk factors and CRP ≥0.3 mg/dL (inter-high group) than in those with 1 risk factor or 2 risk factors with CRP <0.3 mg/dL (inter-low group). IPTW-adjusted Cox regression analysis revealed significant differences in the OS between the inter-low and inter-high groups.

The IMDC prognostic model was active in patients who received first-line axitinib treatment. The combination of CRP value with the number of positive risk factors in the IMDC model might predict prognosis in patients with IMDC intermediate-risk treated with first-line axitinib.

Clinical genitourinary cancer. 2019 Jul 20 [Epub ahead of print]

Sakae Konishi, Shingo Hatakeyama, Kazuyuki Numakura, Shintaro Narita, Takamitsu Inoue, Mitsuru Saito, Noriko Tokui, Hayato Yamamoto, Takahiro Yoneyama, Yasuhiro Hashimoto, Kazuaki Yoshikawa, Satoshi Narita, Toshiaki Kawaguchi, Tomonori Habuchi, Chikara Ohyama

Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan., Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. Electronic address: ., Department of Urology, Akita University Graduate School of Medicine, Akita, Japan., Department of Urology, Mutsu General Hospital, Mutsu, Japan., Department of Urology, Odate Municipal General Hospital, Odate, Japan., Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan.