TY - JOUR
T1 - Urine protein:creatinine ratio vs 24-hour urine protein for proteinuria management
T2 - analysis from the phase 3 REFLECT study of lenvatinib vs sorafenib in hepatocellular carcinoma
AU - Evans, Thomas R.Jeffry
AU - Kudo, Masatoshi
AU - Finn, Richard S.
AU - Han, Kwang Hyub
AU - Cheng, Ann Lii
AU - Ikeda, Masafumi
AU - Kraljevic, Silvija
AU - Ren, Min
AU - Dutcus, Corina E.
AU - Piscaglia, Fabio
AU - Sung, Max W.
N1 - Publisher Copyright:
© 2019, The Author(s), under exclusive licence to Cancer Research UK.
PY - 2019/7/30
Y1 - 2019/7/30
N2 - Background: Proteinuria monitoring is required in patients receiving lenvatinib, however, current methodology involves burdensome overnight urine collection. Methods: To determine whether the simpler urine protein:creatinine ratio (UPCR) calculated from spot urine samples could be accurately used for proteinuria monitoring in patients receiving lenvatinib, we evaluated the correlation between UPCR and 24-hour urine protein results from the phase 3 REFLECT study. Paired data (323 tests, 154 patients) were analysed. Results: Regression analysis showed a statistically significant correlation between UPCR and 24-hour urine protein (R2: 0.75; P < 2 × 10−16). A UPCR cut-off value of 2.4 had 96.9% sensitivity, 82.5% specificity for delineating between grade 2 and 3 proteinuria. Using this UPCR cut-off value to determine the need for further testing could reduce the need for 24-hour urine collection in ~74% of patients. Conclusion: Incorporation of UPCR into the current algorithm for proteinuria management can enable optimisation of lenvatinib treatment, while minimising patient inconvenience. Clinical trial registration: NCT01761266.
AB - Background: Proteinuria monitoring is required in patients receiving lenvatinib, however, current methodology involves burdensome overnight urine collection. Methods: To determine whether the simpler urine protein:creatinine ratio (UPCR) calculated from spot urine samples could be accurately used for proteinuria monitoring in patients receiving lenvatinib, we evaluated the correlation between UPCR and 24-hour urine protein results from the phase 3 REFLECT study. Paired data (323 tests, 154 patients) were analysed. Results: Regression analysis showed a statistically significant correlation between UPCR and 24-hour urine protein (R2: 0.75; P < 2 × 10−16). A UPCR cut-off value of 2.4 had 96.9% sensitivity, 82.5% specificity for delineating between grade 2 and 3 proteinuria. Using this UPCR cut-off value to determine the need for further testing could reduce the need for 24-hour urine collection in ~74% of patients. Conclusion: Incorporation of UPCR into the current algorithm for proteinuria management can enable optimisation of lenvatinib treatment, while minimising patient inconvenience. Clinical trial registration: NCT01761266.
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U2 - 10.1038/s41416-019-0506-6
DO - 10.1038/s41416-019-0506-6
M3 - Article
C2 - 31249394
AN - SCOPUS:85068267197
SN - 0007-0920
VL - 121
SP - 218
EP - 221
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 3
ER -
