The Clinical Significance of Erythrocytic Macrocytosis in Metastatic Renal Cell Cancer and Sarcoma Patients Treated with Pazopanib

Öz

Objective: Pazopanib is a multi-kinase inhibitor used in metastatic renal cell carcinoma or sarcomas (mRCC or mSTS). We aimed to investigate the relationship between pazopanib and macrocytosis and evaluate the clinical significant of this effect in mRCC or mSTS. Methods: Patients diagnosed with mRCC and mSTS and have been treated with pazopanib were included. Drug-induced macrocytosis was defined as MCV >100 fL during any mount of treatment. ΔMCV was defined as difference between MCV during pazopanib treatment and baseline MCV. Data was collected retrospectively. Results: 50 patients were included the study. During the pazopanib treatment, significant increase in MCV levels was observed and the mean MCV at the 0, 1, 3, 6, and 9 months were found as 86.7±7.6 fL, 87.8 ± 7.5, 92.4 ± 8.9, 94.8 ± 11.1 and 99.0 ± 10.7 fL, retrospectively (p<0.001). In the group with ΔMCV3 ≥ 5fL, median PFS was found 48.0 months (95% CI, 26.3-69.9); in the group with ΔMCV3 <5, it was 25 months (95% CI, 14.6-35.4) (p:0.036). Median PFS was 21.0 months (%95 CI, 0-46.3) for macrocytic patients compared to 4.0 months (%95 CI, 2.0-5.9) in normocytic patients (p:0.023).There was no statistically significant difference between the groups for overall survival. Conclusion: A significant increases in MCV values or the development of macrocytosis during the pazopanib treatment in mRCC and mSTS, can be used as an important biomarker for progression-free survival.

Anahtar Kelimeler

• Mean Corpuscular Volume (MCV)
• Macrocytosis
• Pazopanib
• Progression-free Survival

Metastatik Renal Hücreli Kanser ve Metastatik Sarkom Tedavisi Sırasında Gelişen Pazopanib İlişkili Makrositoz’un Klinik Önemi

Öz

Amaç: Pazopanib, metastatik renal hücreli karsinom (mRHK) ve metastatik yumuşak doku kanserlerinde (mYDK) kullanılan multi-kinaz inhibitörüdür. Çalışmamızda pazopanib tedavisinin ortalama eritrosit hacmi (MCV) üzerine etkisinin ve progresyonsuz sağkalım süresi (PSS) ve genel sağkalım süresi (GSS) üzerine etkilerinin incelenmesi amaçlanmıştır. Yöntem: Çalışmamız tek merkezli, retrospektif olarak planlandı ve mRHK veya mYDK tanılı ve pazopanib kullanan hastalar dahil edilmiştir. ΔMCV, tedavinin belli bir ayındaki MCV ile başlangıç MCV arasındaki fark; makrositoz ise tedavinin herhangi bir ayında MCV >100 fL olarak tanımlanmıştır. MCV artışı ve makrositoz ile sağkalım ilişkisi istatiksel olarak analiz edilmiştir. Bulgular: Hasta sayısı 50 idi. Pazopanib ile 0.ay, 1.ay, 3.ay, 6.ay ve 9.ay ortalama MCV değerleri sırasıyla 86,7 ± 7,6, 87,8 ± 7,5, 92,4 ± 8,9, 94,8 ± 11,1 ve 99,0 ± 10,7 fL olarak hesaplandı (p<0,001). Yirmi iki hastanın (%44) üçüncü MCV’si 5 fL ve üzeri artmış olarak bulundu. Hastaların 14’ ünde (%28) makrositoz gelişti. Üçüncü ayda ΔMCV 5 fL ve üstü olanların mPSS 48.0 ay (%95 CI, 26.3-69.9) iken; 5’in altı olanlarda mPSS 25 ay (%95 CI, 14.6-35.4) olarak bulundu (p:0.036). Makrositoz olmayan hastalarda mPSS 4.0 ay iken (%95 CI, 2.0-5.9); makrositoz gelişen hastalarda mPSS 21.0 ay (%95 CI, 0-46.3) olarak bulundu (p: 0.023). ΔMCV ve makrositoz gelişimi ile GSS arasında istatiksel anlamlı bir fark bulunmadı. Sonuç: Pazopanib ile tedavi edilen mRHK ve mYDK’ de, MCV değerlerindeki anlamlı artışın veya makrositoz gelişiminin, prospektif çalışmalar ile valide edildiği takdirde önemli bir gösterge olabileceğini düşünmekteyiz.

Anahtar Kelimeler

• Ortalama eritrosit hacmi (MCV)
• Makrositoz
• Pazopanib
• Progresyonsuz Sağkalım

Kaynakça

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