Prognostic and predictive value of vessels encapsulating tumor clusters (VETC) in renal cell carcinoma (RCC).

医学 舒尼替尼 帕唑帕尼 内科学 肿瘤科 肾细胞癌 危险系数 比例危险模型 置信区间
作者
Salvatore Lorenzo Renne,Marina Valeri,Matteo Perrino,Luca Di Tommaso,Luigi Terracciano,Piergiuseppe Colombo,Paolo Andrea Zucali
出处
期刊:Journal of Clinical Oncology [Lippincott Williams & Wilkins]
卷期号:39 (15_suppl): e16554-e16554 被引量:1
标识
DOI:10.1200/jco.2021.39.15_suppl.e16554
摘要

e16554 Background: VETC has been described as an epithelial-to-mesenchymal-transition independent process of metastasis in hepatocellular carcinoma (HCC): endothelium covers small clusters of neoplastic cells allowing tumor dissemination. It has also been noted that VETC-positive HCCs benefit more from tyrosine kinase inhibitors (TKI) therapy. Interestingly, this type of angiogenesis was also found in RCC - and other cancers - and associated with poor prognosis. The objectives of the present study are: 1) to investigate the prognostic role of VETC in a cohort of primary consecutive RCC. 2) to model the predictive role VETC to TKI response in a cohort of metastatic RCC patients treated with sunitinib or pazopanib. Methods: The study was observational and retrospective. To evaluate the VETC effect on overall survival (OS) for Cox regression, with power .8, Hazard Ratio 2.35, proportion of subject VETC+ .4, proportion of events .6, correlation among covariates .4 and a type I error rate .5, the estimated sample size was n=89. We included consecutive patients undergoing surgery at our institution for primary RCC from 2005 to 2007, (Surgical Series; n=92 cases). Moreover, to investigate the possible role of VETC in predicting TKIs benefit, we considered all RCC patients treated with first line TKIs at our center (TKI Series; sunitinib, n = 39; pazopanib n = 17), and recorded the progression free survival (PFS). VETC was assessed with CD34 immunohistochemistry and defined as a continuous endothelial lining around tumor clusters. We used Bayesian probabilistic modeling to detect small effects and multilevel hierarchical modeling to reduce overfitting. Models were fit using Stan and R. The study was approved by institutional review board (n. 865/20) and registered on ClinicalTrials.gov. Results: VETC+ RCC had a worse prognosis in the Surgical Series, with a posterior probability density (PPD) of median OS of 88 months (mo) (standard deviation, SD: 16 mo) for VETC positive Vs 136 mo (SD: 26 mo) for VETC-; the expected loss of median OS was 48 mo (SD: 31 mo) for patients having a VETC + RCC. Conversely in the TKI Series, VETC+ RCC showed longer PFS compared to VETC- ones: with sunitinib a PPD of median PFS of 35 mo (SD:11 mo) for VETC+ Vs 19 mo (SD: 5 mo) for VETC-. Under Pazopanib a PPD of median PFS of 20 mo (SD: 8 mo) for VETC+ Vs 11 mo (SD: 7 mo) for VETC-. The expected gain of median PFS for of VETC+ cases, was 17 and 9 mo (SD: 12 and 11 mo), respectively in sunitinib and pazopanib treated cases. Conclusions: Our results confirmed the general adverse prognostic role of VETC in RCC, however this phenotype gave a substantial PFS gain for patients treated with TKI, similarly to what have been observed in HCC. VETC could be a new predictive bio-marker that allows the delivery of a personalized treatment: patients affected by RCC might directly benefit from a better selection of already approved drugs.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
Akim应助无私语儿采纳,获得10
刚刚
李健应助story采纳,获得10
1秒前
随波逐流发布了新的文献求助10
2秒前
邓志天完成签到,获得积分10
3秒前
传奇3应助皮皮采纳,获得10
3秒前
3秒前
4秒前
我是老大应助小摩尔采纳,获得10
4秒前
天天快乐应助彳亍采纳,获得10
4秒前
Ava应助Mystic采纳,获得10
4秒前
开朗馒头完成签到,获得积分10
4秒前
huan发布了新的文献求助10
7秒前
拉佛多格完成签到,获得积分10
7秒前
步行街车神ahua完成签到,获得积分10
7秒前
小黄鸭完成签到,获得积分10
8秒前
8秒前
缥缈的飞荷完成签到 ,获得积分10
9秒前
10秒前
10秒前
慕青应助笔花医镜采纳,获得10
10秒前
12秒前
12秒前
12秒前
自然的雁蓉完成签到,获得积分10
12秒前
Singularity应助随波逐流采纳,获得10
13秒前
李爱国应助pkubest采纳,获得10
13秒前
Liury完成签到 ,获得积分10
15秒前
ran123456发布了新的文献求助10
15秒前
上官若男应助柚子采纳,获得10
15秒前
婷婷子发布了新的文献求助20
15秒前
大方的笑萍完成签到 ,获得积分10
15秒前
六六三十六完成签到,获得积分10
16秒前
传奇3应助尔尔采纳,获得30
16秒前
汤飞柏发布了新的文献求助10
16秒前
星河圈揽完成签到,获得积分10
17秒前
story发布了新的文献求助10
17秒前
eden发布了新的文献求助10
17秒前
18秒前
18秒前
高分求助中
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Effective Learning and Mental Wellbeing 300
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3974779
求助须知:如何正确求助?哪些是违规求助? 3519193
关于积分的说明 11197417
捐赠科研通 3255311
什么是DOI,文献DOI怎么找? 1797760
邀请新用户注册赠送积分活动 877150
科研通“疑难数据库(出版商)”最低求助积分说明 806187