Ezrin is a prognostic biomarker in patients with clear cell metastatic renal cell carcinoma receiving sunitinib

Objective: Sunitinib is a novel oral multitargeted tyrosine kinase inhibitor with antitumor and antiangiogenic activities. This study evaluates ezrin expression in sunitinib-treated metastatic clear cell renal cell carcinoma (ccRCC) patients and elucidates its role as a possible marker for survival. Materials and Methods: The expression of ezrin was measured by immunohistochemistry in 80 patients with ccRCC treated by first-line sunitinib between January 2007 and June 2012. Kaplan–Meier curves and log-rank tests were used for analysis of progression-free survival and overall survival (OS), and a multivariate Cox proportional hazard model was employed to identify factors with an independent effect on the survival. Results: In multivariate analysis, liver metastasis (P = 0.018; hazard ratio [HR]: 3.707 (1.257–10.931) and overexpression of ezrin (P = 0.006; HR: 2.993 (1.373–6.523 95% confidence interval) were remained significant factors influencing OS. Overexpression of ezrin in the patients who had progressed in the first 3 months was higher than in the patients who had progressed after 3 months (P = 0.003). The median OS was longer in patients with low levels of ezrin expression (27 months) compared to patients overexpressing ezrin (12 months) (P = 0.001). Conclusion: This is the first study in the literature showing that ezrin status is related with prognosis in patients with metastatic ccRCC.