轉移性腎細胞癌患者接受Cabozantinib治療的預後因子分析：以國際轉移性腎細胞癌聯合資料庫評分(IMDC score)預後因子為基礎

何永、楊啟瑞、張兆祥、吳錫金、黃志平、張議徽、蕭博任、謝博帆、連啟舜、陳冠亨、蔡禮賢、徐明蔚、王又德

中國醫藥大學附設醫院 泌尿部

Use risk factors of International Metastatic RCC Database Consortium (IMDC) to predict the response of cabozatinibin patients with metastatic renal cell carcinoma - a real world analysis

Yung Ho、Chi-Rei Yang、Chao-Hsiang Chang、Hsi-Chin Wu、Chi-Ping Huang、Yi-Huei Chang、Po-Jen Hsiao、Po-Fan, Hsieh、Chi-Shun Lien、Guan-Heng Chen、Li-Hsien Tsai、Ming-wei Hsu、Yu-De Wang

Department of Urology, China Medical University Hospital, Taichung, Taiwan

Purpose: Cabozantinib is authorized for the management of metastatic renal cell carcinoma(mRCC). However, there remains a lack of predictive markers in this scenario. The aim of this study was to evaluate predictive markers of International Metastatic RCC Database Consortium(IMDC) in mRCC patients receiving cabozantinib.

Materials and Methods: A total 56 patients with mRCC were enrolled retrospectively from January, 2000 to March, 2024 in China Medical University Hospital. Of them, 11 patients received second line cabozatinib while 21 patients received cabozantinib as third-line or above therapy.We analyzed treatment response of cabozatinib with IMDC risk model, including less than 1 year from time of diagnosis to systemic therapy, Performance status (ECOG), hemoglobin level (Hb), corrected calcium level (Ca), neutrophil level (Neu) and platelet level(PLT). We demonstrated overall survival (OS), progression-free survival (PFS) in different subgroups using Kaplan-Meier analysis.

Results: In all 56 mRCC cases receiving cabozatinib, the median OS and PFS was 21 months and 9 months, respectively. IMDC group (p<0.001), ECOG <2 (p<0.001), Ca ≤10mg/dL (p=0.048), Neu ≤7000x10^9/L (p=0.002), and PLT ≤400000/uL (p=0.005) were associated with significant longer OS, while IMDC group(p=0.001) and ECOG <2(p<0.001) were associated with significant longer PFS. In the second line group, the median OS and PFS was 30 months and 9 months, respectively. PLT level ≤400000/uL(p=0.002) was associated with significant longer PFS. In the third line group, the median OS and PFS was 43 months and 6 months, respectively. IMDC group(p<0.001), ECOG <2(p<0.001), Ca ≤10mg/dL(p<0.001) were associated with significant longer OS, while only Ca ≤10mg/dL(p=0.028) was associated with significant longer PFS.

Conclusions: According to our analysis, IMDC group and its prognostic factors were associated with treatment response in mRCC patients receiving Cabozantinib, including treatment as as second- or third-line therapy. This real-world study provides evidence of possible prognostic factors in mRCC patients receiving Cabozantinib.