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

J Cancer Res Ther. 2021 Apr-Jun;17(2):408-413. doi: 10.4103/jcrt.JCRT_372_18.


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.

Keywords: Clear cell renal cell carcinoma; ezrin; sunitinib.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / metabolism*
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / secondary
  • Cytoskeletal Proteins / analysis
  • Cytoskeletal Proteins / metabolism*
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Kidney / pathology
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / pathology
  • Male
  • Middle Aged
  • Prognosis
  • Progression-Free Survival
  • Sunitinib / therapeutic use*


  • Biomarkers, Tumor
  • Cytoskeletal Proteins
  • ezrin
  • Sunitinib

Supplementary concepts

  • Clear-cell metastatic renal cell carcinoma