PT  - JOURNAL ARTICLE
AU  - GIGANTE, MARC
AU  - LI, GUORONG
AU  - FERLAY, CELINE
AU  - PEROL, DAVID
AU  - BLANC, ELLEN
AU  - PAUL, STEPHANE
AU  - ZHAO, AN
AU  - TOSTAIN, JACQUES
AU  - ESCUDIER, BERNARD
AU  - NEGRIER, SYLVIE
AU  - GENIN, CHRISTIAN
TI  - Prognostic Value of Serum CA9 in Patients with Metastatic Clear Cell Renal Cell Carcinoma under Targeted Therapy
DP  - 2012 Dec 01
TA  - Anticancer Research
PG  - 5447--5451
VI  - 32
IP  - 12
4099  - http://ar.iiarjournals.org/content/32/12/5447.short
4100  - http://ar.iiarjournals.org/content/32/12/5447.full
SO  - Anticancer Res2012 Dec 01; 32
AB  - Aim: Carbonic anhydrase 9 (CA9) has been found to be one of most powerful biomarkers for clear-cell renal cell carcinoma (RCC). The serum CA9 is detectable. The aim of this study was to evaluate the potential prognostic role of serum CA9 in patients with metastatic clear-cell RCC patients under targeted therapy. Patients and Methods: Serum samples came from the randomized phase 2 TORAVA trial. All patients received a targeted therapy (arm A designed as experimental group: temsirolimus and bevacizumab combination; arm B: sunitinib; arm C: interferon-alfa and bevacizumab). Seventy cases of metastatic clear-cell RCC were analyzed. There were 49 males and 21 females. The age ranged from 33.5 to 79.1 years with a median of 61.2 years. Serum samples were collected before treatment. Serum CA9 was quantified by enzyme-linked immunosorbent assay (ELISA). The correlation of the serum CA9 levels with the clinical parameters, treatment response and overall survival was analyzed. Overall survival estimates were calculated using the Kaplan-Meier method and compared by the log-rank test. Results: Serum concentrations of CA9 ranged between 0 and 897.3 pg/ml, with an average of 94.4±176.6 pg/ml. There was no association between serum CA9 and clinical parameters such as Eastern Cooperative Oncology Group (ECOG) Performance Status (p=0.367) or Motzer classification (p=0.431). The serum CA9 levels were lower in the response group (64.7±104.7 pg/ml) than the no-response group (108.2±203.8 pg/ml), but the difference was not statisticlly significant (p=0.366). For the patient group overall, the Kaplan-Meier survival curve showed that high serum CA9 levels were significantly associated with shorter overall survival (hazard ratio=2.65, 95% confidence interval=1.19-5.92, log-rank test p=0.0136). For the major group of patients treated with temsirolimus and bevacizumab, the Kaplan-Meier survival curve showed that high serum CA9 levels were significantly associated with shorter overall survival (p=0.0006). Conclusion: Serum CA9 levels may be of clinical interest to predict the outcome for patients under targeted therapy for metastatic clear-cell RCC. CA9 may be used to select patients with metastatic clear cell RCC for clinical trials.