Percentage change in mean corpuscular volume (MCV) and survival in patients with advanced renal cell carcinoma receiving sunitinib


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Chern Choy1,Martin Highley2
1Peninsula College of Medicine and Dentistry, UK,2Plymouth Oncology Centre, Derriford Hospital, Plymouth, UK

Abstract

Background

Sunitinib is an established first line treatment for advanced renal cell carcinoma (RCC), but predictive factors for its use are lacking. Mean corpuscular volume (MCV) can increase during sunitinib treatment, but the underlying mechanism and clinical significance is unclear. We have performed a retrospective analysis of changes in MCV in patients with advanced RCC receiving sunitinib, and correlated these with survival.

Method

The case records of patients with advanced RCC commencing first line sunitinib in our oncology centre between January 2012 and March 2015 were reviewed. Percentage change in MCV between the start and end of sunitinib treatment was calculated for each patient, and Kaplan Meier survival curves generated according to the degree of change.

Results

37 patients, (27 (73.0%) male and 10 (27%) female), were included. Median age was 69 years (range 44 to 83). 13 patients (35%) had a prior nephrectomy. Histology was available for 18 (49%) patients (17 clear cell and 1 papillary). 14 (38%) and 23 (62%) of patients fell into the intermediate and poor risk groups of the International Metastatic RCC Database Consortium criteria respectively.

 

Median MCV prior to sunitinib treatment was 85.0 fl (range 69.6 to 97.0). The cut-off point for percentage change in MCV was set at 11.5% after distribution analysis of all values. 18 (48.6%) of patients expressed a change in MCV > 11.5%, and 19 (51.4%) showed an MCV change ≤ 11.5%. The median overall survival of the former group (15.22 months; range 2.85 to 32.09) was significantly greater than that of the latter group (6.24 months; range 0.72 to 29.66) [c2 = 5.861; p = 0.0155].

Conclusion

A high positive percentage change in MCV during sunitinib administration in advanced RCC is associated with a longer survival. The change in MCV may be a potential predictive factor of survival in patients treated with sunitinib.