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• W2011153764 abstract "You have accessJournal of UrologyKidney Cancer: Advanced1 Apr 2014MP57-14 CHANGE IN PLATELET COUNT AS A PROGNOSTIC INDICATOR FOR RESPONSE TO NEOADJUVANT TYROSINE KINASE INHIBITOR THERAPY IN METASTATIC RENAL CELL CARCINOMA Hak Lee, Nishant Patel, Ryan Kopp, Michael Liss, Reza Mehrazin, Ramzi Jabaji, Song Wang, Fuad Elkoury, Jason Woo, Kerrin Palazzi, Anthony Patterson, Christopher Kane, Fred Millard, and Ithaar Derweesh Hak LeeHak Lee More articles by this author , Nishant PatelNishant Patel More articles by this author , Ryan KoppRyan Kopp More articles by this author , Michael LissMichael Liss More articles by this author , Reza MehrazinReza Mehrazin More articles by this author , Ramzi JabajiRamzi Jabaji More articles by this author , Song WangSong Wang More articles by this author , Fuad ElkouryFuad Elkoury More articles by this author , Jason WooJason Woo More articles by this author , Kerrin PalazziKerrin Palazzi More articles by this author , Anthony PattersonAnthony Patterson More articles by this author , Christopher KaneChristopher Kane More articles by this author , Fred MillardFred Millard More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1789AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Biomarkers may be useful as prognostic indicators prior to and during systemic therapy. We evaluated change in platelet count (ΔPlt) as a biomarker for response to neoadjuvant tyrosine kinase inhibitor (TKI) therapy for metastatic renal cell carcinoma (mRCC). Methods Multi-center retrospective study of mRCC patients undergoing neoadjvant TKI therapy from 5/2005-8/2013. ΔPlt was defined as post-treatment Plt after first cycle minus pre-treatment Plt. Primary outcome was response of disease to TKI defined by RECIST criteria for partial response (PR), stable disease (SD), and progressive disease (PD). Demographic and clinical characteristics were analyzed between subgroups with stable/increased (+ΔPlt) and decreased (-ΔPlt) counts. Cox proportional hazards model evaluated factors associated with changes in tumor response. Kaplan-Meier analysis estimated overall survival (OS) and compared Plt groups with log-rank test. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated for ΔPlt and disease response PR/SD. Results A total of 69 patients treated with neoadjuvant TKI therapy were analyzed for ΔPlt. Overall, 15 patients (22%) were noted to have +ΔPlt and 54 (78%) had –ΔPlt after neoadjuvant TKI therapy. There were no other differences in clinical or demographic variables between these two groups (comorbidities, ECOG, tumor size, number of metastases, stage, grade and number of TKI cycles). Patients with +ΔPlt count had a lower post TKI treatment creatinine (1.0 vs. 1.3, p=0.041). PD was more common among +ΔPlt 86.7% vs. –ΔPlt 33.3%, (p=0.001), and SD/PR was more common in –ΔPlt 66.7% vs. +ΔPlt 13.3%, (p=0.001). On MVA, -ΔPlt below baseline was a significant predictor of SD/PR (OR 6.96, p=0.028). A Kaplan Meier analysis (Figure) demonstrated a higher overall survival in -ΔPlt versus +ΔPlt (p=0.009), with median survival 13.8 of and 5.7 months respectively. -ΔPlt had sensitivity of 94.7%, specificity of 41.9%, PPV of 66.7% and NPV of 86.7% for PR/SD after neoadjuvant TKI therapy. Conclusions Patients with -ΔPlt were more likely to respond to TKI therapy and had longer median overall survival. Further investigation is requisite to determine the utility of ΔPlt as a biomarker for RCC response to TKI. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e647 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Hak Lee More articles by this author Nishant Patel More articles by this author Ryan Kopp More articles by this author Michael Liss More articles by this author Reza Mehrazin More articles by this author Ramzi Jabaji More articles by this author Song Wang More articles by this author Fuad Elkoury More articles by this author Jason Woo More articles by this author Kerrin Palazzi More articles by this author Anthony Patterson More articles by this author Christopher Kane More articles by this author Fred Millard More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2011153764 title "MP57-14 CHANGE IN PLATELET COUNT AS A PROGNOSTIC INDICATOR FOR RESPONSE TO NEOADJUVANT TYROSINE KINASE INHIBITOR THERAPY IN METASTATIC RENAL CELL CARCINOMA" @default.
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