Prognostic value of serum C-reactive protein level prior to second-line treatment in intermediate risk metastatic renal cell carcinoma patients

Kimiharu Takamatsu, Ryuichi Mizuno, Nobuyuki Tanaka, Toshikazu Takeda, Shinya Morita, Kazuhiro Matsumoto, Takeo Kosaka, Toshiaki Shinojima, Eiji Kikuchi, Hiroshi Asanuma, Masafumi Oyama, Shuji Mikami, Mototsugu Oya

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Background: The later-line treatment of metastatic renal cell carcinoma (mRCC) has been drastically changing by the development of immune-oncology drugs and molecular targeted treatment in recent years. Although the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model is useful for second-line setting, this model has the problem that over 50% patients are classified as intermediate risk group. The aim of this study is to evaluate whether the serum C-reactive protein (CRP) levels prior to second-line treatment could divide intermediate risk group patients. Methods: We retrospectively reviewed 82 consequent intermediate-risk mRCC patients who received second-line molecular targeted therapy. We classified patients who had serum CRP higher than 0.5 mg/dl in elevated CRP group because the median baseline serum CRP level before second-line treatment was 0.51 mg/dl. We assessed the prognostic impact of serum CRP levels prior to second-line treatment initiation to predict overall survival (OS). Results: Thirty-three out of 82 (40%) patients demonstrated elevated baseline CRP levels. The median OS of elevated and non-elevated CRP group was 11.5 (95% CI 5.4–17.5) and 29.4 (95% CI 25.5–33.5) months, respectively (p = 0.001). The serum CRP elevation could predict prognosis in intermediate risk patients treated with second-line treatment (HR 2.5, 95% CI 1.4–4.2, p = 0.001). Conclusions: The serum CRP levels after first-line treatment termination could divide intermediate risk group mRCC patients into two prognostic subgroups in second-line targeted treatment setting.

Original languageEnglish
JournalInternational Journal of Clinical Oncology
Publication statusPublished - 2019 Jan 1



  • Biomarkers
  • C-reactive protein
  • Neoplasm metastasis
  • Prognosis
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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