External validation of the albumin, C-reactive protein and lactate dehydrogenase model in patients with metastatic renal cell carcinoma receiving second-line axitinib therapy in a Japanese multi-center cohort.

To externally validate the utility of the albumin, C-reactive protein and lactate dehydrogenase model to predict the overall survival of previously treated metastatic renal cell carcinoma patients.

The ability of the albumin, C-reactive protein and lactate dehydrogenase model to predict overall survival was validated and compared with those of other prognostication models using data from 421 metastatic renal cell carcinoma patients receiving second-line axitinib therapy at 36 hospitals belonging to the Japan Urologic Oncology Group.

The following factors in this cohort were independently associated with poor overall survival in a multivariate analysis: a low Karnofsky performance status, <1 year from diagnosis to targeted therapy, a high neutrophil count, and low albumin, elevated C-reactive protein, and elevated lactate dehydrogenase, and the Japan Urologic Oncology Group model was newly developed based on the presence/absence of these independent factors. In this cohort, 151 (35.9%), 125 (27.7%) and 145 (34.4%) patients were classified into the favorable, intermediate and poor risk groups, respectively, according to the albumin, C-reactive protein and lactate dehydrogenase model; however, the proportions of patients in the intermediate risk group stratified by the Japan Urologic Oncology Group, Memorial Sloan Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium models were >50%. The superiority of the albumin, C-reactive protein and lactate dehydrogenase model to the Memorial Sloan Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium models, but not the Japan Urologic Oncology Group model, was demonstrated by multiple statistical analyses.

The utility of the albumin, C-reactive protein and lactate dehydrogenase model as a simple and objective prognostication tool was successfully validated using data from 421 metastatic renal cell carcinoma patients receiving second-line axitinib.

Japanese journal of clinical oncology. 2021 Jan 22 [Epub ahead of print]

Keita Tamura, Takahiro Osawa, Ario Takeuchi, Keita Minami, Yasutomo Nakai, Kosuke Ueda, Michinobu Ozawa, Motohide Uemura, Mikio Sugimoto, Kojiro Ohba, Toshihiro Suzuki, Satoshi Anai, Tetsuya Shindo, Naohisa Kusakabe, Motokiyo Komiyama, Ken Tanaka, Akira Yokomizo, Naoki Kohei, Nobuo Shinohara, Hideaki Miyake, Japanese Urological Oncology Group

Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan., Department of Urology, Hokkaido University Hospital, Sapporo, Japan., Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Department of Urology, Sapporo City General Hospital, Sapporo, Japan., Department of Urology, Osaka International Cancer Institute, Osaka, Japan., Department of Urology, Kurume University Hospital, Kurume, Japan., Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan., Department of Urology, Osaka University Hospital, Suita, Japan., Department of Urology, Kagawa University, Takamatsu, Japan., Department of Urology, Nagasaki University Hospital, Nagasaki, Japan., Department of Urology, Shinshu University Hospital, Matsumoto, Japan., Department of Urology, Nara Medical University, Kashihara, Japan., Department of Urology, Sapporo Medical University, Sapporo, Japan., Department of Urology, Obihiro Kosei Hospital, Obihiro, Japan., Department of Urology, National Cancer Center Hospital, Chiba, Japan., Department of Urology, University of Tsukuba Hospital, Tsukuba, Japan., Department of Urology, Harasanshin Hospital, Fukuoka, Japan., Department of Urology, Shizuoka General Hospital, Shizuoka, Japan.