TY - JOUR
T1 - Active smokingmay negatively affect response rate, progression-free survival, and overall survival of patients with metastatic renal cell carcinoma treatedwith sunitinib
AU - Keizman, Daniel
AU - Gottfried, Maya
AU - Ish-Shalom, Maya
AU - Maimon, Natalie
AU - Peer, Avivit
AU - Neumann, Avivit
AU - Hammers, Hans
AU - Eisenberger, Mario A.
AU - Sinibaldi, Victoria
AU - Pili, Roberto
AU - Hayat, Henry
AU - Kovel, Svetlana
AU - Sella, Avishay
AU - Boursi, Ben
AU - Weitzen, Rony
AU - Mermershtain, Wilmosh
AU - Rouvinov, Keren
AU - Berger, Raanan
AU - Carducci, Michael A.
PY - 2014
Y1 - 2014
N2 - Obesity, smoking, hypertension, and diabetes are risk factors forrenal cell carcinomadevelopment.Theirpresence has been associated with a worse outcome in various cancers. We sought to determine their association with outcome of sunitinib treatment in metastatic renal cell carcinoma (mRCC). Methods. An international multicenter retrospective study of sunitinib-treated mRCC patients was performed. Multivariate analyses were performed to determine the association between outcome and the pretreatment status of smoking, body mass index, hypertension, diabetes, and other known prognostic factors. Results. Between 2004 and 2013, 278 mRCC patients were treated with sunitinib: 59 were active smokers, 67 were obese, 73 were diabetic, and 165 had pretreatment hypertension. Median progression-free survival (PFS) was 9 months, and overall survival (OS) was 22 months. Factors associated with PFS were smoking status (past and active smokers: hazard ratio [HR]: 1.17, p=.39; never smokers: HR: 2.94, p<.0001), non-clear cell histology (HR: 1.62, p =.011), pretreatment neutrophil-to-lymphocyte ratio.3 (HR: 3.51, p<.0001), use of angiotensin system inhibitors (HR: 0.63, p =.01), sunitinib dose reduction or treatment interruption (HR: 0.72, p=.045), and Heng risk (good and intermediate risk: HR: 1.07, p =.77; poor risk: HR: 1.87, p=.046). Factors associated with OS were smoking status (past and active smokers: HR: 1.25, p 5.29; never smokers: HR: 2.7, p<.0001), pretreatment neutrophilto- lymphocyte ratio.3 (HR: 2.95, p<.0001), and sunitinibinduced hypertension (HR: 0.57, p =.002). Conclusion. Active smoking may negatively affect the PFS and OS of sunitinib-treated mRCC. Clinicians should consider advising patients to quit smoking at initiation of sunitinib treatment for mRCC.
AB - Obesity, smoking, hypertension, and diabetes are risk factors forrenal cell carcinomadevelopment.Theirpresence has been associated with a worse outcome in various cancers. We sought to determine their association with outcome of sunitinib treatment in metastatic renal cell carcinoma (mRCC). Methods. An international multicenter retrospective study of sunitinib-treated mRCC patients was performed. Multivariate analyses were performed to determine the association between outcome and the pretreatment status of smoking, body mass index, hypertension, diabetes, and other known prognostic factors. Results. Between 2004 and 2013, 278 mRCC patients were treated with sunitinib: 59 were active smokers, 67 were obese, 73 were diabetic, and 165 had pretreatment hypertension. Median progression-free survival (PFS) was 9 months, and overall survival (OS) was 22 months. Factors associated with PFS were smoking status (past and active smokers: hazard ratio [HR]: 1.17, p=.39; never smokers: HR: 2.94, p<.0001), non-clear cell histology (HR: 1.62, p =.011), pretreatment neutrophil-to-lymphocyte ratio.3 (HR: 3.51, p<.0001), use of angiotensin system inhibitors (HR: 0.63, p =.01), sunitinib dose reduction or treatment interruption (HR: 0.72, p=.045), and Heng risk (good and intermediate risk: HR: 1.07, p =.77; poor risk: HR: 1.87, p=.046). Factors associated with OS were smoking status (past and active smokers: HR: 1.25, p 5.29; never smokers: HR: 2.7, p<.0001), pretreatment neutrophilto- lymphocyte ratio.3 (HR: 2.95, p<.0001), and sunitinibinduced hypertension (HR: 0.57, p =.002). Conclusion. Active smoking may negatively affect the PFS and OS of sunitinib-treated mRCC. Clinicians should consider advising patients to quit smoking at initiation of sunitinib treatment for mRCC.
KW - Active smoking
KW - Metastatic renal cell carcinoma
KW - Outcome
KW - Sunitinib treatment
UR - http://www.scopus.com/inward/record.url?scp=84892585606&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2012-0335
DO - 10.1634/theoncologist.2012-0335
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C2 - 24309979
AN - SCOPUS:84892585606
SN - 1083-7159
VL - 19
SP - 51
EP - 60
JO - Oncologist
JF - Oncologist
IS - 1
ER -