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      Body Mass Index in Patients Treated with Cabozantinib for Advanced Renal Cell Carcinoma: A New Prognostic Factor?

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          Abstract

          We analyzed the clinical and pathological features of renal cell carcinoma (RCC) patients treated with cabozantinib stratified by body mass index (BMI). We retrospectively collected data from 16 worldwide centers involved in the treatment of RCC. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan–Meier curves. Cox proportional models were used at univariate and multivariate analyses. We collected data from 224 patients with advanced RCC receiving cabozantinib as second- (113, 5%) or third-line (111, 5%) therapy. The median PFS was significantly higher in patients with BMI ≥ 25 (9.9 vs. 7.6 months, p < 0.001). The median OS was higher in the BMI ≥ 25 subgroup (30.7 vs. 11.0 months, p = 0.003). As third-line therapy, both median PFS (9.2 months vs. 3.9 months, p = 0.029) and OS (39.4 months vs. 11.5 months, p = 0.039) were longer in patients with BMI ≥ 25. BMI was a significant predictor for both PFS and OS at multivariate analysis. We showed that a BMI ≥ 25 correlates with longer survival in patients receiving cabozantinib. BMI can be easily assessed and should be included in current prognostic criteria for advanced RCC.

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          Nivolumab plus Ipilimumab versus Sunitinib in Advanced Renal-Cell Carcinoma

          Nivolumab plus ipilimumab produced objective responses in patients with advanced renal-cell carcinoma in a pilot study. This phase 3 trial compared nivolumab plus ipilimumab with sunitinib for previously untreated clear-cell advanced renal-cell carcinoma.
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            Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma

            The combination of pembrolizumab and axitinib showed antitumor activity in a phase 1b trial involving patients with previously untreated advanced renal-cell carcinoma. Whether pembrolizumab plus axitinib would result in better outcomes than sunitinib in such patients was unclear.
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              Avelumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma

              In a single-group, phase 1b trial, avelumab plus axitinib resulted in objective responses in patients with advanced renal-cell carcinoma. This phase 3 trial involving previously untreated patients with advanced renal-cell carcinoma compared avelumab plus axitinib with the standard-of-care sunitinib.
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                Author and article information

                Journal
                Diagnostics (Basel)
                Diagnostics (Basel)
                diagnostics
                Diagnostics
                MDPI
                2075-4418
                18 January 2021
                January 2021
                : 11
                : 1
                : 138
                Affiliations
                [1 ]Oncology Unit, Macerata Hospital, Via Santa Lucia 2, 62100 Macerata, Italy; giulia.sorgentoni@ 123456libero.it (G.S.); nicola.battelli@ 123456sanita.marche.it (N.B.)
                [2 ]Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; fmassari79@ 123456gmail.com
                [3 ]Medical and Translational Oncology Unit, Department of Oncology, AziendaOspedaliera Santa Maria, 05100 Terni, Italy; sergio.bracarda@ 123456gmail.com
                [4 ]Department of Medical Oncology, Istituto Nazionale dei Tumori IRCCS, 20133 Milan, Italy; giuseppe.procopio@ 123456istitutotumori.mi.it
                [5 ]Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust (AOUI Verona), P.le L.A. Scuro 10, 37134 Verona, Italy; michele.milella@ 123456univr.it
                [6 ]Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; ugo_degiorgi@ 123456yahoo.com
                [7 ]Department of Medical Oncology, Istituto Oncologico Veneto IOV IRCCS, 35128 Padova, Italy; umberto.basso@ 123456iov.veneto.it
                [8 ]Medical Oncology Division of Urogenital and Head and Neck Tumours, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; gaetano.aurilio@ 123456ieo.it
                [9 ]Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), Section of Medical Oncology, University of Palermo, 90127 Palermo, Italy; lorena.incorvaia@ 123456unipa.it
                [10 ]Dipartimento Oncologico USL Sud-Est Toscana-Area Senese, Località Campostaggia s.n.c., 53036 Poggibonsi, Italy; angelo.martignetti@ 123456uslsudest.toscana.it
                [11 ]Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy; rizzo.mimma@ 123456gmail.com
                [12 ]Department of Medical Oncology, AO “A. Cardarelli”, 80131 Naples, Italy; cartenigiacomo@ 123456gmail.com
                [13 ]Department of Medical Oncology, MD Anderson Cancer Center, 28033 Madrid, Spain; egrande@ 123456mdanderson.es
                [14 ]Department of Internal Medicine, Hematology/Oncology, Ochsner Medical Center, New Orleans, LA 70121, USA; mamatrana@ 123456ochsner.org
                [15 ]Southampton Clinical Trials Unit, University of Southampton, Southampton SO16 5AF, UK; S.J.Crabb@ 123456southampton.ac.uk
                [16 ]Urologic Oncology, Champalimaud Clinical Center, 1400-038 Lisbon, Portugal; nuno.vau@ 123456fundacaochampalimaud.pt
                [17 ]Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, 60126 Ancona, Italy; a.cimadamore@ 123456staff.univpm.it (A.C.); r.montironi@ 123456staff.univpm.it (R.M.)
                Author notes
                [* ]Correspondence: mattymo@ 123456alice.it ; Tel.: +39-073-3257-2553
                Author information
                https://orcid.org/0000-0001-6476-6871
                https://orcid.org/0000-0002-5075-2177
                https://orcid.org/0000-0002-1199-7286
                https://orcid.org/0000-0003-3521-9064
                https://orcid.org/0000-0001-5981-3514
                Article
                diagnostics-11-00138
                10.3390/diagnostics11010138
                7831923
                33477676
                d4132980-4d5d-4289-b8f8-65118a36169f
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 22 December 2020
                : 14 January 2021
                Categories
                Article

                body mass index,cabozantinib,obesity,prognosis,real-world data,renal cell carcinoma,targeted therapy

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