ecancermedicalscience

Clinical Study

Conditional survival of metastatic renal cell carcinoma patients treated with high-dose interleukin-2

29 Sep 2016
David M Gill, David D Stenehjem, Kinjal Parikh, Joseph Merriman, Arun Sendilnathan, Archana M Agarwal, Andrew W Hahn, Sumati Gupta, Srinivas Kiran Tantravahi, Wolfram E Samlowski, Neeraj Agarwal

Conditional survival (CS) is a clinically useful prediction measure which adjusts a patient’s prognosis based on their duration of survival since initiation of therapy. CS has been described in numerous malignancies, and recently described in patients with metastatic renal cell carcinoma (mRCC) who received vascular endothelial growth factor tyrosine kinase inhibitor (VEGFTKI) therapy. However, CS has been not reported in the context of mRCC treated with high-dose interleukin-2 therapy (HDIL-2). A total of 176 patients with histologically confirmed metastatic clear cell RCC (mccRCC) treated with HDIL-2 at the University of Utah Huntsman Cancer Institute from 1988–2012 were evaluated. Using the Heng/IMDC model, they were stratified by performance status and prognostic risk groups. Two-year CS was defined as the probability of surviving an additional two years from initiation of HDIL-2 to 18 months after the start of HDIL-2 at three-month intervals. The median overall survival (OS) was 19.9 months. Stratifying patients into favourable (n = 35; 20%), intermediate (n = 110; 63%), and poor (n = 31; 18%) prognostic groups resulted in median OS of 47.5 (HR 0.57, 95% CI 0.35–0.88, p = 0.0106 versus intermediate), 19.6 (HR 0.33, 95% CI 0.10–0.33, p < 0.0001 versus poor), and 8.8 (HR 5.34, 95% CI 3.00–9.62, p < 0.0001 versus favourable) months respectively. Two-year overall CS increased from 43% at therapy initiation to 100% at 18 months. These results have significant ramifications in prognostication. Furthermore, it is important when counseling patients with mccRCC who have completed treatment with HDIL-2 and are in active follow-up.

Related Articles

Koreddi A Dora, Vaka Rajashekhar, Mahadevapura R Kaushik, Gaurav Vora, Arti Sarin, Amol Patel
Rachael O Oduyemi, Chizoma Millicent Ndikom, Gloria Oluwakorede Alao, Iyanuoluwa O Ojo, Faith Ayomide Ajayi, Damilola Ajibade, Abdullahi Suleiman, Hameedah Ayomide Gbadamosi, Oluwadamilare Akingbade
Kaio Mota-Ribeiro, Maria P Curado, Betine P M Iser, Mohsen Naghavi, Deborah C Malta, Max M Oliveira
Agnes Chipo Tererai, Margaret Borok, Zvavahera Mike Chirenje, Liz Gwyther, Lindsay Farrant, Ntokozo Ndlovu, Simbarashe Rusakaniko
Elhadji Daouda Niang, Seynabou Fall, Sokhna Aissatou Toure, Marieme Lolita Camara, Modou Moustapha Ciss, Adjaratou Tiane Niang, Khadim Sarr, Amy Thiam, Fatou Samba Diago Ndiaye
Prajwal Dhakal, Christopher S Wichman, Shailesh Simkhada, Bunny J Pozehl, Radowan Elnair, Amulya Yellala, Kalika Mahato, Vijaya Raj Bhatt