442 ROLE OF MOLECULAR MARKERS IN NEPHRECTOMY SPECIMEN AS PROGNOSTICATORS FOR PATIENTS WITH METASTATIC RENAL CELL CARCINOMA IN THE ERA OF TARGETED THERAPY

Abstract

You have accessJournal of UrologyKidney Cancer: Basic Research III1 Apr 2012442 ROLE OF MOLECULAR MARKERS IN NEPHRECTOMY SPECIMEN AS PROGNOSTICATORS FOR PATIENTS WITH METASTATIC RENAL CELL CARCINOMA IN THE ERA OF TARGETED THERAPY Dalsan You, Yong Mee Cho, Jae-Lyun Lee, Cheryn Song, Jun Hyuk Hong, Choung-Soo Kim, and Hanjong Ahn Dalsan YouDalsan You Seoul, Korea, Republic of More articles by this author , Yong Mee ChoYong Mee Cho Seoul, Korea, Republic of More articles by this author , Jae-Lyun LeeJae-Lyun Lee Seoul, Korea, Republic of More articles by this author , Cheryn SongCheryn Song Seoul, Korea, Republic of More articles by this author , Jun Hyuk HongJun Hyuk Hong Seoul, Korea, Republic of More articles by this author , Choung-Soo KimChoung-Soo Kim Seoul, Korea, Republic of More articles by this author , and Hanjong AhnHanjong Ahn Seoul, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.509AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recently, the molecular biological alterations associated with clear cell type renal cell carcinoma (RCC) development and progression have been identified and agents that target relevant biologic pathways, including VEGF and PDGF, have been developed for metastatic RCC. We investigated the expression levels of molecular markers in radical nephrectomy specimens from patients with metastatic RCC treated with tyrosine kinase inhibitors (TKIs) in order to identify factors predicting susceptibility to this agent. METHODS We reviewed the medical records of 84 patients presented with synchronous metastatic RCC and had not received any systemic therapy. Eligibility criteria for TKI therapy and analysis included the presence of clear cell type RCC, as determined by histologic assessment of nephrectomy or biopsy specimens; measurable disease. Thirty-two patients, who underwent nephrectomy with immunohistochemical staining, were included for analysis. Following staining for VEGF, VEGFR-2, PDGF-β, and PDGFR-β in nephrectomy specimens, results were interpreted by a genitourinary pathologist. The expression levels for each marker were classified into the four groups, and negative, (+) and (++), (+++) were integrated into weak and strong expressions for analysis. RESULTS Median age was 55.5 years (range 36 to 72). Twenty-eight patients (88%) were males and 23 (72%) were treated with sunitinib. Eight (25%) patients had a response, including 1 complete response, and 17, 7 showed stable, progressive diseases, respectively. Of clinicpathological factors examined, the expression level of PDGF-β was shown to have significant impacts on response to TKIs, along with Karnofsky performance status, hemoglobin, number of metastatic sites and bone metastasis. PFS was significantly associated with Karnofsky performance status, hemoglobin, sarcomatoid feature and number of metastatic sites on univariate analysis. Of these significant factors, hemoglobin and number of metastatic sites appeared to be independently related to PFS on multivariate analysis. There was no molecular marker having significant impact on the survival. CONCLUSIONS These findings suggest that it would be useful to consider expression levels of potential molecular markers, particularly PDGF-β, as well as conventional clinicopathological factors to select metastatic RCC patients likely to response to treatment with TKIs. However, these markers did not predict PFS in patients treated with TKIs for metastatic RCC. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e181 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dalsan You Seoul, Korea, Republic of More articles by this author Yong Mee Cho Seoul, Korea, Republic of More articles by this author Jae-Lyun Lee Seoul, Korea, Republic of More articles by this author Cheryn Song Seoul, Korea, Republic of More articles by this author Jun Hyuk Hong Seoul, Korea, Republic of More articles by this author Choung-Soo Kim Seoul, Korea, Republic of More articles by this author Hanjong Ahn Seoul, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...