On-treatment neutropenia and hypertension are independent biomarkers of efficacy in patients with metastatic renal cell carcinoma (mRCC), a recent study published online ahead of print in the British Journal of Cancer has shown.1

For the study, researchers led by Frede Donskov, MD, DMSc, of the Aarhus University Hospital Department of Oncology in Denmark, sought to evaluate whether mRCC prognostic models may be improved by including sunitinib-induced toxicities.

Researchers analyzed data from 770 patients with mRCC treated with the tyrosine kinase inhibitor sunitinib. They looked at baseline prognostic factors, treatment-induced toxicities, such as hypertension, neutropenia, thrombocytopenia, hand-foot syndrome, and asthenia/fatigue, and progression-free and overall survival.

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Results showed that on-treatment neutropenia and hypertension were significantly independently associated with longer progression-free survival (P = .0276 and P < .0001, respectively) and overall survival (P =.0014 and P < .0001, respectively.

By landmark analysis at 12 weeks, neutropenia was significantly associated with longer progression-free and overall survival (P = .013 and P =.0122, respectively, while hypertension or hand-foot syndrome were associated with longer overall survival (P =.0036 and P =.0218, respectively).

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The findings suggest that including neutropenia and hypertension as independent biomarkers of sunitinib efficacy may add prognostic accuracy to the International Metastatic Renal Cell carcinoma Database Consortium (IMDC) criteria.

In a clinical trial that included 375 patients with treatment-naïve advanced RCC who received sunitinib, 34% experienced hypertension and 77% experienced neutropenia.


  1. Donskov F, Michaelson MD, Puzanov I, et al. Sunitinib-associated hypertension and neutropenia as efficacy biomarkers in metastatic renal cell carcinoma patients [published online ahead of print October 22, 2015]. Br J Cancer. doi: 10.1038/bjc.2015.368.