Document Detail


Prognostic value of serum CA9 in patients with metastatic clear cell renal cell carcinoma under targeted therapy.
MedLine Citation:
PMID:  23225450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Carbonic anhydrase 9 (CA9) has been found to be one of most powerful biomarkers for clear-cell renal cell carcinoma (RCC). The serum CA9 is detectable. The aim of this study was to evaluate the potential prognostic role of serum CA9 in patients with metastatic clear-cell RCC patients under targeted therapy.
PATIENTS AND METHODS: Serum samples came from the randomized phase 2 TORAVA trial. All patients received a targeted therapy (arm A designed as experimental group: temsirolimus and bevacizumab combination; arm B: sunitinib; arm C: interferon-alfa and bevacizumab). Seventy cases of metastatic clear-cell RCC were analyzed. There were 49 males and 21 females. The age ranged from 33.5 to 79.1 years with a median of 61.2 years. Serum samples were collected before treatment. Serum CA9 was quantified by enzyme-linked immunosorbent assay (ELISA). The correlation of the serum CA9 levels with the clinical parameters, treatment response and overall survival was analyzed. Overall survival estimates were calculated using the Kaplan-Meier method and compared by the log-rank test.
RESULTS: Serum concentrations of CA9 ranged between 0 and 897.3 pg/ml, with an average of 94.4±176.6 pg/ml. There was no association between serum CA9 and clinical parameters such as Eastern Cooperative Oncology Group (ECOG) Performance Status (p=0.367) or Motzer classification (p=0.431). The serum CA9 levels were lower in the response group (64.7±104.7 pg/ml) than the no-response group (108.2±203.8 pg/ml), but the difference was not statisticlly significant (p=0.366). For the patient group overall, the Kaplan-Meier survival curve showed that high serum CA9 levels were significantly associated with shorter overall survival (hazard ratio=2.65, 95% confidence interval=1.19-5.92, log-rank test p=0.0136). For the major group of patients treated with temsirolimus and bevacizumab, the Kaplan-Meier survival curve showed that high serum CA9 levels were significantly associated with shorter overall survival (p=0.0006).
CONCLUSION: Serum CA9 levels may be of clinical interest to predict the outcome for patients under targeted therapy for metastatic clear-cell RCC. CA9 may be used to select patients with metastatic clear cell RCC for clinical trials.
Authors:
Marc Gigante; Guorong Li; Celine Ferlay; David Perol; Ellen Blanc; Stephane Paul; An Zhao; Jacques Tostain; Bernard Escudier; Sylvie Negrier; Christian Genin
Publication Detail:
Type:  Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anticancer research     Volume:  32     ISSN:  1791-7530     ISO Abbreviation:  Anticancer Res.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  2013-05-02     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  8102988     Medline TA:  Anticancer Res     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  5447-51     Citation Subset:  IM    
Affiliation:
Department of Urology and Kidney Transplantation, CHU La Réunion, 97405 Saint Denis cedex, La Réunion, France. marc.gigante@chu-reunion.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antibodies, Monoclonal, Humanized / administration & dosage
Antigens, Neoplasm / blood*
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Carbonic Anhydrases / blood*
Carcinoma, Renal Cell / drug therapy*,  enzymology*,  pathology
Enzyme-Linked Immunosorbent Assay
Female
Humans
Indoles / therapeutic use*
Interferon-alpha / administration & dosage
Kidney Neoplasms / drug therapy*,  enzymology*,  pathology
Male
Middle Aged
Molecular Targeted Therapy
Neoplasm Metastasis
Pyrroles / therapeutic use*
Sirolimus / administration & dosage,  analogs & derivatives
Treatment Outcome
Tumor Markers, Biological / blood
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Humanized; 0/Antigens, Neoplasm; 0/Indoles; 0/Interferon-alpha; 0/Pyrroles; 0/Tumor Markers, Biological; 0/sunitinib; 0/temsirolimus; 2S9ZZM9Q9V/bevacizumab; 53123-88-9/Sirolimus; EC 4.2.1.1/CA9 protein, human; EC 4.2.1.1/Carbonic Anhydrases

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