The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study
Background: Tyrosine-kinase inhibitors (TKIs) and immunotherapy represent the backbone treatment for metastatic renal cell carcinoma (mRCC) patients. The aim of the present study was to describe mean corpuscular volume (MCV) and red cell distribution width (RDW) in mRCC patients treated with pazopan...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-07-01
|
| Series: | Therapeutic Advances in Urology |
| Online Access: | https://doi.org/10.1177/17562872231187216 |
| _version_ | 1797774666921672704 |
|---|---|
| author | Chiara Tommasi Giulia Scartabellati Diana Giannarelli Ugo De Giorgi Nicole Brighi Giuseppe Fornarini Sara Elena Rebuzzi Silvia Puglisi Orazio Caffo Stefania Kinspergher Alessia Mennitto Carlo Cattrini Matteo Santoni Elena Verzoni Alessandro Rametta Marco Stellato Andrea Malgeri Giandomenico Roviello Matteo Brunelli Sebastiano Buti |
| author_facet | Chiara Tommasi Giulia Scartabellati Diana Giannarelli Ugo De Giorgi Nicole Brighi Giuseppe Fornarini Sara Elena Rebuzzi Silvia Puglisi Orazio Caffo Stefania Kinspergher Alessia Mennitto Carlo Cattrini Matteo Santoni Elena Verzoni Alessandro Rametta Marco Stellato Andrea Malgeri Giandomenico Roviello Matteo Brunelli Sebastiano Buti |
| author_sort | Chiara Tommasi |
| collection | DOAJ |
| description | Background: Tyrosine-kinase inhibitors (TKIs) and immunotherapy represent the backbone treatment for metastatic renal cell carcinoma (mRCC) patients. The aim of the present study was to describe mean corpuscular volume (MCV) and red cell distribution width (RDW) in mRCC patients treated with pazopanib or cabozantinib, and to explore their potential impact on oncological outcomes. Materials and methods: We conducted a multicenter retrospective observational study in mRCC patients treated with pazopanib or cabozantinib between January 2012 and December 2020 in nine Italian centers. Descriptive statistics, univariate, and multivariate analyses were performed. Objectives: The primary endpoints were the incidence and trend over time of anemia, macrocytosis (elevated MCV), and anisocytosis (elevated RDW). The secondary endpoints were the correlations of MCV and RDW with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Results: A total of 301 patients were enrolled; mean Hb value was 12.5 g/dl, a mean increase of 1 g/dl was observed at day 15 and maintained at 3 months. Most patients had baseline macrocytosis (MCV levels > 87 fl), with a significant mean increase after 3 months of treatment. At univariate analysis patients with macrocytosis had better ORR, longer PFS, and OS. About one third of patients had baseline anisocytosis (RDW > 16%), with a significant mean increase after 3 months of treatment. At univariate analysis, patients with RDW values ⩽ 16% had higher ORR, longer PFS, and OS. At multivariate analysis, baseline macrocytosis was significantly associated with better PFS in patients treated with pazopanib and baseline anisocytosis with shorter OS in all patients. Conclusions: mRCC patients treated with pazopanib or cabozantinib may have baseline macrocytosis and anisocytosis. A significant increase of Hb, MCV, and RDW after TKIs start was observed. Baseline macrocytosis is positively correlated with PFS in patients treated with pazopanib and baseline anisocytosis affects survival of patients treated with TKIs. |
| first_indexed | 2024-03-12T22:24:25Z |
| format | Article |
| id | doaj.art-2c36da92decd496ba6b3b43f3902e571 |
| institution | Directory Open Access Journal |
| issn | 1756-2880 |
| language | English |
| last_indexed | 2024-03-12T22:24:25Z |
| publishDate | 2023-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Urology |
| spelling | doaj.art-2c36da92decd496ba6b3b43f3902e5712023-07-22T13:03:40ZengSAGE PublishingTherapeutic Advances in Urology1756-28802023-07-011510.1177/17562872231187216The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective studyChiara TommasiGiulia ScartabellatiDiana GiannarelliUgo De GiorgiNicole BrighiGiuseppe FornariniSara Elena RebuzziSilvia PuglisiOrazio CaffoStefania KinspergherAlessia MennittoCarlo CattriniMatteo SantoniElena VerzoniAlessandro RamettaMarco StellatoAndrea MalgeriGiandomenico RovielloMatteo BrunelliSebastiano ButiBackground: Tyrosine-kinase inhibitors (TKIs) and immunotherapy represent the backbone treatment for metastatic renal cell carcinoma (mRCC) patients. The aim of the present study was to describe mean corpuscular volume (MCV) and red cell distribution width (RDW) in mRCC patients treated with pazopanib or cabozantinib, and to explore their potential impact on oncological outcomes. Materials and methods: We conducted a multicenter retrospective observational study in mRCC patients treated with pazopanib or cabozantinib between January 2012 and December 2020 in nine Italian centers. Descriptive statistics, univariate, and multivariate analyses were performed. Objectives: The primary endpoints were the incidence and trend over time of anemia, macrocytosis (elevated MCV), and anisocytosis (elevated RDW). The secondary endpoints were the correlations of MCV and RDW with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Results: A total of 301 patients were enrolled; mean Hb value was 12.5 g/dl, a mean increase of 1 g/dl was observed at day 15 and maintained at 3 months. Most patients had baseline macrocytosis (MCV levels > 87 fl), with a significant mean increase after 3 months of treatment. At univariate analysis patients with macrocytosis had better ORR, longer PFS, and OS. About one third of patients had baseline anisocytosis (RDW > 16%), with a significant mean increase after 3 months of treatment. At univariate analysis, patients with RDW values ⩽ 16% had higher ORR, longer PFS, and OS. At multivariate analysis, baseline macrocytosis was significantly associated with better PFS in patients treated with pazopanib and baseline anisocytosis with shorter OS in all patients. Conclusions: mRCC patients treated with pazopanib or cabozantinib may have baseline macrocytosis and anisocytosis. A significant increase of Hb, MCV, and RDW after TKIs start was observed. Baseline macrocytosis is positively correlated with PFS in patients treated with pazopanib and baseline anisocytosis affects survival of patients treated with TKIs.https://doi.org/10.1177/17562872231187216 |
| spellingShingle | Chiara Tommasi Giulia Scartabellati Diana Giannarelli Ugo De Giorgi Nicole Brighi Giuseppe Fornarini Sara Elena Rebuzzi Silvia Puglisi Orazio Caffo Stefania Kinspergher Alessia Mennitto Carlo Cattrini Matteo Santoni Elena Verzoni Alessandro Rametta Marco Stellato Andrea Malgeri Giandomenico Roviello Matteo Brunelli Sebastiano Buti The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study Therapeutic Advances in Urology |
| title | The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study |
| title_full | The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study |
| title_fullStr | The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study |
| title_full_unstemmed | The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study |
| title_short | The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study |
| title_sort | role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors the marecap retrospective study |
| url | https://doi.org/10.1177/17562872231187216 |
| work_keys_str_mv | AT chiaratommasi theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT giuliascartabellati theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT dianagiannarelli theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT ugodegiorgi theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT nicolebrighi theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT giuseppefornarini theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT saraelenarebuzzi theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT silviapuglisi theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT oraziocaffo theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT stefaniakinspergher theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT alessiamennitto theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT carlocattrini theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT matteosantoni theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT elenaverzoni theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT alessandrorametta theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT marcostellato theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT andreamalgeri theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT giandomenicoroviello theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT matteobrunelli theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT sebastianobuti theroleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT chiaratommasi roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT giuliascartabellati roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT dianagiannarelli roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT ugodegiorgi roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT nicolebrighi roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT giuseppefornarini roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT saraelenarebuzzi roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT silviapuglisi roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT oraziocaffo roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT stefaniakinspergher roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT alessiamennitto roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT carlocattrini roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT matteosantoni roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT elenaverzoni roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT alessandrorametta roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT marcostellato roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT andreamalgeri roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT giandomenicoroviello roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT matteobrunelli roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy AT sebastianobuti roleofmeancorpuscularvolumeandredcelldistributionwidthinpatientswithmetastaticrenalcellcarcinomatreatedwithtyrosinekinaseinhibitorsthemarecapretrospectivestudy |