Prognostic significance of sarcopenia and decreased relative dose intensity during the initial two cycles of first-line sunitinib for metastatic renal cell carcinoma

Abstract

Targeted therapy for metastatic renal cell carcinoma (mRCC) treatment requires the identification of clinically important factors that can predict the therapeutic effect. We retrospectively investigated the prognostic roles of pre-treatment sarcopenia and relative dose intensity during the initial two cycles (2c-RDI) of sunitinib treatment in patients with mRCC. In total, 41 (52.6%) patients were classified as having sarcopenia and 16 (20.5%) patients were classified with low 2c-RDI at <75%. The mean dose reduction during sunitinib treatment was higher for sarcopenic than for non-sarcopenic patients. The median progression-free survival (PFS) and overall survival (OS) were significantly shorter in sarcopenic patients with low 2c-RDI (n = 14, 17.9%) than in non-sarcopenic patients with high 2c-RDI (n = 35, 44.9%). Multivariate analysis identified sarcopenia and low 2c-RDI as poor prognostic factors for PFS and OS. Our findings provide new insights into the prognostic role of sarcopenia and 2c-RDI for targeted therapy in mRCC.

Keywords:

• Renal cell carcinoma
• relative dose intensity
• sarcopenia
• sunitinib
• targeted therapy

Additional information

Funding

This work was supported by the 2019 Inje University research grant.

Notes on contributors

Chan Ho Lee

Chan Ho Lee, MD, PhD, Assistant Professor of Department of Urology in Inje University Busan Paik Hospital. He is responsible for overall query and writing this article.

Ja Yoon Ku

Ja Yoon Ku, MD, PhD, Assistant Professor of Department of Urology in Pusan National University Hospital. He is responsible for the revision of the article and production of charts.

Won Ik Seo

Won Ik Seo, MD, Assistant Professor of Department of Urology in Inje University Busan Paik Hospital. He is responsible for the statistics and verification of the data.

Young Joo Park

Young Joo Park, MD, Assistant Professor of Department of Internal Medicine in Pusan National University Hospital. She is responsible for the revision of the article and production of charts.

Jae Il Chung

Jae Il Chung, MD, PhD, Professor of Department of Urology in Inje University Busan Paik Hospital. He is responsible for the collecting and verification of the data.

Wansuk Kim

Wansuk Kim, MD, PhD, Assistant Professor of Department of Urology in Inje University Busan Paik Hospital. He is responsible for the collecting and verification of the data.

Tae Yong Park

Tae Yong Park, MD, Assistant Professor of Department of Urology in Inje University Busan Paik Hospital. He is responsible for the collecting and verification of the data.

Hong Koo Ha

Hong Koo Ha, MD, PhD, Associate Professor of Department of Urology in Pusan National University Hospital. He is responsible for providing the ideas of this article, and finalization of the final article