Prognostic factors in patients receiving third line targeted therapy for metastatic renal cell carcinoma

Roberto Iacovelli, Alessio Farcomeni, Cora N. Sternberg, Giacomo Cartenì, Michele Milella, Matteo Santoni, Linda Cerbone, Giuseppe Di Lorenzo, Elena Verzoni, Cinzia Ortega, Roberto Sabbatini, Riccardo Ricotta, Caterina Messina, Vito Lorusso, Francesco Atzori, Fabio De Vincenzo, Cosimo Sacco, Francesco Boccardo, Francesco Valduga, Francesco MassariValentina Baldazzi, Saverio Cinieri, Alessandra Mosca, Enzo Maria Ruggeri, Alfredo Berruti, Giuseppe Procopio

Research output: Contribution to journalArticlepeer-review


Purpose Several prognostic models have been proposed for metastatic renal cell carcinoma but none has been validated in patients who receive third line targeted agents. We evaluated prognostic factors in patients with metastatic renal cell carcinoma who received a third line targeted agent. Materials and Methods We retrospectively reviewed data on 2,065 patients with clear cell metastatic renal cell carcinoma who were treated with targeted therapy at a total of 23 centers in Italy. Included in final analysis were 281 patients treated with 3 targeted agents. Overall survival was the main outcome. Cox proportional hazards regression followed by bootstrap validation was used to identify independent prognostic factors. Results Three clinical characteristics (ECOG performance status greater than 1, metastasis at diagnosis and liver metastasis) and 2 biochemical factors (hemoglobin less than the lower limit of normal and neutrophil count greater than the upper limit of normal, respectively) were prognostic. Patients were classified into 3 risk categories, including low - zero or 1, intermediate - 2 and high risk - more than 2 risk factors. Median overall survival was 19.7, 10.1 and 5.5 months, and 1-year overall survival was 71%, 43% and 15%, respectively. The major limitation was the retrospective nature of this study and absent external validation. Conclusions This nomogram included clinical and biochemical prognostic factors. In clinical trials it may be useful to select patients and define the prognosis.

Original languageEnglish
Pages (from-to)1905-1910
Number of pages6
JournalJournal of Urology
Issue number6
Publication statusPublished - Jun 1 2015


  • carcinoma
  • kidney
  • neoplasm metastasis
  • nomograms
  • prognosis
  • renal cell

ASJC Scopus subject areas

  • Urology
  • Medicine(all)


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