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.

Article metrics: 682 views
246
436

Related Articles

Richard Ofori-Asenso, Oyepeju Ogundipe, Akosua Adom Agyeman, Ken Lee Chin, Mohsen Mazidi, Zanfina Ademi, Marie Louise De Bruin, Danny Liew
Akhil Kapoor, Vanita Noronha, Vijay M Patil, Amit Joshi, Nandini Menon, Abhishek Mahajan, Amit Janu, Kumar Prabhash
Charlien Berghen, Steven Joniau, Christof Vulsteke, Maarten Albersen, Gaëtan Devos, Kato Rans, Karin Haustermans, Gert De Meerleer
Milan Terzic, Melanie Norton, Sanja Terzic, Gauri Bapayeva, Gulzhanat Aimagambetova
Barbara Buonomo, Roberto Orecchia, Federica Tomao, Lino Del Pup, Alex Garcia-Faura, Fedro A Peccatori