Table 2. Best tumour response, progression-free survival and overall survival.
|
Best tumour response
|
||||||
|---|---|---|---|---|---|---|
| PR | SD | PD | NE | Median PFSa | Median OSa | |
| Variable | n (%) | n (%) | n (%) | n (%) | Months (range) | Months (range) |
| All patients | 19 (23) | 41 (50) | 16 (20) | 6 (7) | 9.3 (0.5–18.3) | 15.0 (0.5–19.4) |
| Histology | P=0.528 | P=0.105 | ||||
| Clear cell histology | 19 (23) | 31 (38) | 12 (15) | 6 (7) | 9.3 (0.5–18.3) | 15.0 (0.5–19.4) |
| Non-clear cell histology | 0 (0) | 10 (12) | 4 (5) | 0 (0) | 3.2 (1.2–17.0) | 6.5 (1.4–18.4) |
| ECOG performance status | P=0.397 | P=0.049 | ||||
| ECOG ⩽1 | 14 (17) | 34 (41) | 12 (15) | 2 (2) | 9.4 (1.2–17.0) | NR (1.8–18.9) |
| ECOG >1 | 5 (6) | 6 (7) | 3 (4) | 3 (4) | 8.9 (0.5–18.3) | 9.7 (0.5–19.4) |
| Unknown | 0 (0) | 1 (1) | 1 (1) | 1 (1) | 1.2 (1.2–13.2) | 2.2 (0.5–13.2) |
| MSKCC risk groups b | P=0.001 | P<0.001 | ||||
| 0 (favourable) | 6 (7) | 11 (13) | 2 (2) | 1 (1) | 11.6 (1.1–17.0) | NR (2.0–18.9) |
| 1–2 (intermediate) | 9 (11) | 23 (28) | 7 (9) | 2 (2) | 9.6 (1.2–18.3) | 15.4 (4.3–19.4) |
| ⩾3 (poor) | 2 (2) | 6 (7) | 7 (9) | 2 (2) | 2.6 (0.5–17.0) | 3.6 (0.5–16.5) |
| Unknown | 2 (2) | 1 (1) | 0 (0) | 1 (1) | 9.7 (9.3–13.2) | 15.0 (0.5–15.0) |
| Choueiri risk groups c | P=0.007 | P=0.002 | ||||
| 1 (0 or 1 adverse prognostic factor) | 3 (4) | 8 (10) | 4 (5) | 1 (1) | 12.2 (1.2–17.0) | NR (3.6–18.9) |
| 2 (2 adverse prognostic factors) | 8 (10) | 8 (10) | 1 (1) | 1 (1) | 12.2 (2.1–18.3) | NR (4.7–19.4) |
| 3 (>2 adverse prognostic factors) | 8 (10) | 25 (30) | 11 (13) | 4 (5) | 7.0 (0.5–16.1) | 10.8 (0.5–17.7) |
| Number of disease sites | P=0.096 | P=0.039 | ||||
| 1 | 1 (1) | 7 (9) | 2 (2) | 1 (1) | NR (1.2–17.0) | NR (3.6–17.2) |
| 2 | 11 (9) | 13 (16) | 5 (6) | 2 (2) | 9.7 (0.9–18.3) | NR (1.5–19.4) |
| ⩾3 | 7 (9) | 21 (26) | 9 (11) | 3 (4) | 8.4 (0.5–16.1) | 11.0 (0.5–18.4) |
| Miscellaneous | ||||||
| Concurrent primary tumour | 6 (7) | 6 (7) | 4 (5) | 0 (0) | 9.3 (0.9–16.1) | 15.0 (1.4–17.7) |
| Concurrent brain metastases | 0 (0) | 2 (2) | 2 (2) | 1 (1) | 3.0 (2.6–12.2) | 7.5 (3.6–18.4) |
| Previous cytokine-based therapy | 14 (17) | 27 (33) | 8 (10) | 4 (5) | 10.6 (1.2–18.3) | NR (0.5–19.4) |
| Previous antiangiogenic therapy | 1 (1) | 1 (1) | 2 (2) | 1 (1) | 2.6 (1.2–18.3) | 4.6 (3.6–19.4) |
ECOG=Eastern Cooperative Oncology Group; LDH=lactate dehydrogenase; MSKCC=Memorial Sloan–Kettering Cancer Center; NE=not evaluable; NR=median not reached; OS=overall survival; PD=progressive disease; PFS=progression-free survival; PR=partial response; SD=stable disease; VEGF=vascular endothelial growth factor.
Median PFS and OS were calculated with the Kaplan–Meier method.
Risk groups according to MSKCC prognostic criteria (based on the five risk factors: low Karnofsky performance status (<80%), high LDH (>1.5 times the upper limit of normal), low serum haemoglobin, high-corrected serum calcium (>10 mg per 100 ml) and time from initial diagnosis to treatment of less than 1 year; Motzer et al, 2002).
Prognostic risk groups for VEGF-targeted therapy according to Chouieri et al (2007) (based on the five risk factors: time from diagnosis to treatment <2 years, baseline platelet count >300 × 109 l−1, baseline neutrophil count >4.5 × 109 l−1, baseline corrected calcium <8.5 mg per 100 ml or >10 mg per 100 ml and initial ECOG performance status >0).