Charlson Comorbidity Index a valuable tool in estimating renal cell carcinoma prognosis

Use of the Charlson Comorbidity Index (CCI) appears to be beneficial for assessing prognosis and optimizing therapy in patients with advanced renal cell carcinoma who are receiving first-line sunitinib or pazopanib, suggests a recent study.

Of the 102 patients included, 64 received first-line sunitinib and 38 pazopanib. Forty-two patients (41.9 percent) had a CCI of ≥9. Dose-limiting toxicities occurred more frequently in those with CCI ≥9 (69 percent vs 40 percent; p=0.004). CCI was independently associated with dose-limiting toxicity (hazard ratio [HR], 4.30; p=0.002).

After adjusting for other variables, it was found that CCI ≥9 was also a significant prognostic factor for progression-free (HR, 1.76; p=0.02) and overall survival (HR, 1.75; p=0.03).

In this study, the investigators retrospectively examined the files of locally advanced and metastatic renal cell carcinoma patients, who received first-line sunitinib or pazopanib, and calculated the CCI for each participant. Patients were then stratified into Memorial Sloan-Kettering Cancer Center risk groups.

Binomial logistic regression analysis was conducted to evaluate the predictors of dose-limiting toxicity, and univariate and multivariate Cox regression models were generated to determine the prognostic factors for survival.

“Antiangiogenic tyrosine kinase inhibitors, sunitinib and pazopanib, have proven efficacy in advanced renal cell carcinoma, with specific adverse events occurring during treatment process,” the investigators said. “Comorbidities can reflect functional status and have prognostic value in oncology patients.”