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Anpalakhan S, Banna GL, Rebuzzi SE, Fornarini G, Maruzzo M, Zucali PA, Catalano F, Antonj L, Tudini M, Fratino L, Malgeri A, Rescigno P, Signori A, Acunzo A, Silini EM, Mazzaschi G, Buti S. A red blood cell-based score in the prognostication of patients with metastatic RCC of the Meet-URO 15 study. Immunotherapy 2024:1-11. [PMID: 39105621 DOI: 10.1080/1750743x.2024.2382666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/17/2024] [Indexed: 08/07/2024] Open
Abstract
Aims: Anemia, mean corpuscular volume and red cell distribution width may have some effects on survival outcomes of metastatic renal cell carcinoma (mRCC) patients and are incorporated in a red blood cell (RBC)-based score. Its validity in prognostication of mRCC patients treated with second-line nivolumab was assessed. Patients and methods: Retrospective analysis using Meet-URO-15 cohort of mRCC patients receiving nivolumab in the second-line setting or beyond. Outcomes were overall survival (OS) and progression-free survival (PFS). Results: A total of 390 patients were included. Significant differences in OS and PFS between RBC-based score groups, with group 1 (2 or 3 of the RBC-related prognostic factors) having longer OS (median 29.5 months, 95% CI: 23.1-35.9, versus 11.5 months, 95% CI: 8.5-22.6; p < 0.001) and PFS (7.5 months, 95% CI: 5.5-10.2, versus 4.2 months, 95% CI: 3.3-5.9; p = 0.040) than those in group 0 (0 or 1 RBC-related prognostic factors). Belonging to group 1 independently predicted OS (hazard ratio: 0.65, 95% CI: 0.50-0.85; p = 0.002) but not PFS (hazard ratio: 0.89, 95% CI: 0.70-1.14, p = 0.370) or disease response (OR 0.68, 95% CI: 0.41-1.10; p = 0.118) at multivariable analysis. Conclusion: RBC-based group scores independently predicted OS in mRCC patients treated with nivolumab.
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Affiliation(s)
- Shobana Anpalakhan
- Southampton General Hospital, University Hospital Southampton NHS Trust, UK
| | - Giuseppe Luigi Banna
- Southampton General Hospital, University Hospital Southampton NHS Trust, UK
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Sara Elena Rebuzzi
- Medical Oncology Unit, Ospedale San Paolo, Savona, Italy
- Department of Internal Medicine & Medical Specialties (Di.M.I.), University of Genova, Genova, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Marco Maruzzo
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Paolo Andrea Zucali
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Oncology, IRCCS, Humanitas Clinical & Research Center, Rozzano, Milano, Italy
| | - Fabio Catalano
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Ludovica Antonj
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Lucia Fratino
- Department of Medical Oncology, Centro di Riferimento, Oncologico di Aviano CRO-IRCCS, Aviano, Italy
| | - Andrea Malgeri
- Department of Medical Oncology, Fondazione Policlinico Campus Bio-Medico, Roma, Italy
| | - Pasquale Rescigno
- Translational & Clinical Research Institute, Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
- Candiolo Cancer Institute, FPO-IRCCS, Turin, Italy
| | - Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genova, Genova, Italy
| | - Alessandro Acunzo
- Department of Medicine & Surgery, University of Parma, Parma, Italy
- Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Enrico Maria Silini
- Department of Medicine & Surgery, University of Parma, Parma, Italy
- Pathology Unit, University Hospital of Parma, Parma, Italy
| | - Giulia Mazzaschi
- Department of Medicine & Surgery, University of Parma, Parma, Italy
- Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Sebastiano Buti
- Department of Medicine & Surgery, University of Parma, Parma, Italy
- Oncology Unit, University Hospital of Parma, Parma, Italy
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Maffezzoli M, Santoni M, Mazzaschi G, Rodella S, Lai E, Maruzzo M, Basso U, Bimbatti D, Iacovelli R, Anghelone A, Fiala O, Rebuzzi SE, Fornarini G, Lolli C, Massari F, Rosellini M, Mollica V, Nasso C, Acunzo A, Silini EM, Quaini F, De Filippo M, Brunelli M, Banna GL, Rescigno P, Signori A, Buti S. External validation of a red cell-based blood prognostic score in patients with metastatic renal cell carcinoma treated with first-line immunotherapy combinations. Clin Exp Metastasis 2024; 41:117-129. [PMID: 38363410 PMCID: PMC10973030 DOI: 10.1007/s10585-024-10266-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/04/2024] [Indexed: 02/17/2024]
Abstract
Immunotherapy combinations with tyrosine-kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) had significantly improved outcomes of patients with mRCC. Predictive and prognostic factors are crucial to improve patients' counseling and management. The present study aimed to externally validate the prognostic value of a previously developed red cell-based score, including hemoglobin (Hb), mean corpuscular volume (MCV) and red cell distribution width (RDW), in patients with mRCC treated with first-line immunotherapy combinations (TKI plus ICI or ICI plus ICI). We performed a sub-analysis of a multicentre retrospective observational study (ARON-1 project) involving patients with mRCC treated with first-line immunotherapy combinations. Uni- and multivariable Cox regression models were used to assess the correlation between the red cell-based score and progression-free survival (PFS), and overall survival (OS). Logistic regression were used to estimate the correlation between the score and the objective response rate (ORR). The prognostic impact of the red cell-based score on PFS and OS was confirmed in the whole population regardless of the immunotherapy combination used [median PFS (mPFS): 17.4 vs 8.2 months, HR 0.66, 95% CI 0.47-0.94; median OS (mOS): 42.0 vs 17.3 months, HR 0.60, 95% CI 0.39-0.92; p < 0.001 for both]. We validated the prognostic significance of the red cell-based score in patients with mRCC treated with first-line immunotherapy combinations. The score is easy to use in daily clinical practice and it might improve patient counselling.
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Affiliation(s)
- Michele Maffezzoli
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
- Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Matteo Santoni
- Oncology Unit, Macerata Hospital, 62100, Macerata, Italy
| | - Giulia Mazzaschi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Sara Rodella
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Eleonora Lai
- Department of Oncology, Oncology Unit, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | - Marco Maruzzo
- Department of Oncology, Oncology Unit, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | - Umberto Basso
- Department of Oncology, Oncology Unit, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | - Davide Bimbatti
- Department of Oncology, Oncology Unit, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | - Roberto Iacovelli
- Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Annunziato Anghelone
- Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Ondřej Fiala
- Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic
- Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Sara Elena Rebuzzi
- Medical Oncology Unit, Ospedale San Paolo, Savona, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, Genoa, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cristian Lolli
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Matteo Rosellini
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Veronica Mollica
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Cecilia Nasso
- Medical Oncology, Ospedale Santa Corona, 17027, Pietra Ligure, Italy
| | - Alessandro Acunzo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Enrico Maria Silini
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Pathology Unit, University Hospital of Parma, Parma, Italy
| | - Federico Quaini
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Massimo De Filippo
- Department of Medicine and Surgery, Section of Radiology, University of Parma, Parma, Italy
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Giuseppe L Banna
- Department of Oncology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
- Faculty of Science and Health, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Pasquale Rescigno
- Centre for Cancer, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Alessio Signori
- Section of biostatistics, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | - Sebastiano Buti
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
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Li S, Wang H. Research Progress on Mechanism and Management of Adverse Drug Reactions of Anlotinib. Drug Des Devel Ther 2023; 17:3429-3437. [PMID: 38024530 PMCID: PMC10657757 DOI: 10.2147/dddt.s426898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Anti-angiogenesis therapy plays a vital role in the treatment of tumors, with anlotinib as its representative targeted drug. Anlotinib is a novel oral tyrosine kinase inhibitor (TKI) with inhibitory effects on tumor growth tumor angiogenesis. In Phase III clinical trials, anlotinib demonstrated better overall survival and progression-free survival than placebo in patients with advanced non-small cell lung cancer (NSCLC), and was approved for the first time as a third-line treatment for refractory advanced NSCLC. Going far beyond that, anlotinib has shown encouraging results in a variety of malignancies, including medullary thyroid carcinoma, renal cell carcinoma, gastric cancer and esophageal squamous cell carcinoma. Nevertheless, anlotinib has been subject to some controversy in terms of adverse events due to its widespread use. In this review, the mechanism of action, pharmacokinetic characteristics, adverse reactions in clinical use and management of anlotinib were summarized.
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Affiliation(s)
- Shiting Li
- Department of Pharmacy, Inner Mongolia Baogang Hospital, Baotou City, Inner, Mongolia, People’s Republic of China
| | - Hongqin Wang
- Department of Pharmacy, Inner Mongolia Baogang Hospital, Baotou City, Inner, Mongolia, People’s Republic of China
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