Development and validation of a prognostic nomogram for progression-free survival in patients with advanced renal cell carcinoma treated with pazopanib

Abstract

Objective: To develop and validate a prognostic nomogram for predicting the probability of 12-month progression-free survival (PFS) for patients receiving first-line pazopanib for advanced renal cell carcinoma (RCC). Methods: Statistical modeling was performed with data from 557 pazopanib-treated patients in the phase 3 COMPARZ trial. A multivariable Cox model was fit using known prognostic indicators. Variables included neutrophil count, serum levels of albumin and alkaline phosphatase, time from diagnosis to treatment, and bone metastases. Data from the pazopanib arm of a placebo-controlled phase 3 trial were used for validation. Results: The model included ten prognostic variables and was plotted as a nomogram for predicting the probability of 12-month PFS. Calibration plots suggested reasonable correspondence between predicted probabilities and actual proportions of PFS. The concordance index for 12-month PFS was 0.625. Significant associations (p < 0.05) were observed between PFS and bone metastases, time from diagnosis to treatment, albumin, and alkaline phosphatase. Albumin and alkaline phosphatase appeared to be influential predictors. Conclusion: The nomogram predicts, with reasonable accuracy, PFS in patients with advanced RCC receiving pazopanib, based on their baseline clinical characteristics.