PMID- 21304400
OWN - NLM
STAT- MEDLINE
DCOM- 20110526
LR  - 20131121
IS  - 1537-4513 (Electronic)
IS  - 1524-9557 (Linking)
VI  - 34
IP  - 2
DP  - 2011 Mar
TI  - Combined immunochemotherapy in selected patients with metastatic renal cell 
      carcinoma: HLA class II genotype can help to predict response to therapy.
PG  - 196-201
LID - 10.1097/CJI.0b013e3182027748 [doi]
AB  - A number of new agents have been approved for systemic therapy of metastatic 
      renal cell carcinoma (mRCC) recently. Thereby, prognostic factors may aid in 
      predicting the effectiveness of various treatment modalities in individual cases. 
      Aim of this study was to determine the value of human leukocyte antigen (HLA) 
      class II characteristics in predicting response of mRCC to combined 
      immunochemotherapy (ICT). A retrospective study of 29 patients with mRCC treated 
      with ICT was performed: 17 patients (group A) with long-term remission and 12 
      (group B) with progressive disease after ICT. DNA was used for high resolution 
      typing of HLA-DRB1, -DRB3, -DRB4, -DRB5, -DQA1, and -DQB1. Statistical evaluation 
      started with Classification and Regression Trees analysis. The assignment of 
      single alleles to the groups was then aggregated to create a classification on a 
      patients' basis. Finally, the accuracy of this test algorithm was evaluated. 
      HLA-DRB1 (DRB1*0301*0401*0402*0407*1101*1501=progression) was the strongest 
      discriminator between the 2 groups. The test algorithm defined all patients with 
      at least one of these DRB1 alleles to be progressive after ICT. Thus, 12 of 12 
      patients of group B could have been identified as progressive (sensitivity=100%). 
      However, only 10 of 17 patients of group A would have been identified as 
      responding (specificity=58%). Thus, the test had a positive and negative 
      predictive value of 63% and 100%, respectively. Approximately 5% to 10% of all 
      patients with mRCC are able to benefit from ICT with long-term remission. HLA 
      class II characteristics may aid in identifying this small subgroup of patients 
      with mRCC.
FAU - Bierer, Stefan
AU  - Bierer S
AD  - Department of Urology, Institute of Medical Informatics and Biomathematics, 
      University Hospital of Muenster, Muenster, Germany. 
      bierers@mednet.uni-muenster.de
FAU - Hoffmeister, Ina
AU  - Hoffmeister I
FAU - Gerss, Joachim
AU  - Gerss J
FAU - Herrmann, Edwin
AU  - Herrmann E
FAU - Wulfing, Christian
AU  - Wulfing C
FAU - Sibrowski, Walter
AU  - Sibrowski W
FAU - Hertle, Lothar
AU  - Hertle L
FAU - Kelsch, Reinhard
AU  - Kelsch R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Immunother
JT  - Journal of immunotherapy (Hagerstown, Md. : 1997)
JID - 9706083
RN  - 0 (Histocompatibility Antigens Class II)
RN  - U3P01618RT (Fluorouracil)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Algorithms
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Carcinoma, Renal Cell/*diagnosis/secondary/*therapy
MH  - Combined Modality Therapy
MH  - Female
MH  - Fluorouracil/administration & dosage
MH  - Genotype
MH  - Histocompatibility Antigens Class II/*genetics
MH  - Histocompatibility Testing
MH  - Humans
MH  - *Immunotherapy
MH  - Kidney Neoplasms/*diagnosis/secondary/*therapy
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Analysis
EDAT- 2011/02/10 06:00
MHDA- 2011/05/27 06:00
CRDT- 2011/02/10 06:00
PHST- 2011/02/10 06:00 [entrez]
PHST- 2011/02/10 06:00 [pubmed]
PHST- 2011/05/27 06:00 [medline]
AID - 10.1097/CJI.0b013e3182027748 [doi]
PST - ppublish
SO  - J Immunother. 2011 Mar;34(2):196-201. doi: 10.1097/CJI.0b013e3182027748.