Considerable data is now available to help predicting the outcome for patients with advanced renal cancer receiving systemic therapy. Factors that have been variably associated with response
and survival include Karnofsky performance status < 80%, time from diagnosis to treatment < 12 months, corrected serum calcium > 10 mg/dL, Hemoglobin below the lower limit of normal, and LDH > 1.5 times the upper limit of normal. Patients considered to have a favorable profile are those with no poor prognostic factors present; intermediate group patients have 1–2 factors present; and patients with an unfavorable profile have > 2 factors present. This is a Memorial Sloan Kettering learn more Cancer Center (MSKCC) model developed by Motzer et al. [6, 7]. Several poor prognostic factors have been identified in ARCC trial (efficacy and safety of temsirolimus in previously untreated patients with metastatic RCC), such as number of organs with metastases (2 selleckchem and more) and interval from original diagnosis to the start of systemic therapy . Moreover, disorders in hemostatic system such as hypercoagulability can impact on tumor growth. We evaluated rate of abnormal coagulation in metastatic RCC, correlation between levels of disorders,
number of metastatic sites; determine response rate, disease progression and survival in patients with or without abnormal coagulation who had received immunotherapy. Methods Patients The study population consisted of patients who had metastatic
RCC with any type of histology. Patients Lonafarnib research buy who had not received previous systemic therapies for metastatic disease were included in the analysis. Other key eligibility criteria for analysis included the presence of measurable disease, adequate hepatic, renal, and cardiac function. Patients were ineligible if they had brain metastases, life expectancy of less than 4 month, thrombocytosis, indication for anticoagulant treatment (for example, mechanic heart valves, inferior vena cava filter, previous venous thromboembolism, or atrial fibrillation), medical contraception. Study design and methods of evaluation Retrospective analysis of 289 patients entering on institutional review board-approved clinical trials was conducted between 2003 and 2006 at the N.N. Blokhin Russian Cancer Research Center. In addition, two groups of patients with (n = 28) or without (n = 28) hypercoagulability were compared in a case-control study. Baseline and treatment characteristics were well balanced. All 56 patients previously received at least 2 cycles of low-dose immunotherapy (interleukin-2, 1 MU, i.v, 3 tiw and interferon alfa 2b, 5 MU, s.c, 3 tiw – 3 weeks on, 3 weeks off). Patients were compared by MSKCC prognostic score.