Prognostic factors for survival following initiation of second-line treatment with everolimus for metastatic renal cell carcinoma: evidence from a nationwide sample of clinical practice in the United States |
| |
Authors: | Michael K Wong Eric Jonasch Sumanta K Pal James E Signorovitch Peggy L Lin Xufang Wang |
| |
Institution: | 1. University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA;2. Anderson Cancer Center, Houston, TX, USA;3. City of Hope Comprehensive Cancer Center, Duarte, CA, USA;4. Analysis Group, Inc., Boston, 111 Huntington Ave, 10th Floor, MA, USA +1 617 425 8475;5. +1 617 425 8001;6. Peggy.Lin@analysisgroup.com;7. Novartis Pharmaceuticals Corp., East Hanover, NJ, USA |
| |
Abstract: | Objective: Comparing prognostic factors for overall survival (OS) in community-practice metastatic renal cell carcinoma (mRCC) patients receiving second-line everolimus with those previously reported in clinical trials. Research design and methods: Two separate chart sets (2009 – 2012) were used to develop and validate a prognostic model for patients initiating second-line everolimus after first-line tyrosine kinase inhibitor (TKI). Main outcome measures: Prognostic factors for OS have been identified and validated in separate samples. Results: One-year OS probabilities in the study (n = 220) and validation (n = 97) samples were 68 and 67%; median OS was 19 and 23 months – higher than the 1-year OS of 60% and median OS of 14.8 months of RECORD-1. Karnofsky performance score < 80%, duration of mRCC < 1 year, progression on first-line TKI, liver metastasis and clear cell histology were significant prognostic factors for shorter survival. One-year OS estimates were 84% for validation sample patients with 0 – 2 risk factors, 63% for 3 risk factors and 22% for 4 – 5 risk factors (log-rank p < 0.001). Conclusion: Real-world prognostic factors for OS following second-line everolimus for mRCC were largely consistent with those previously identified in trial data; however, OS was longer in the practice setting than in clinical trials and was not associated with type of first-line TKI. |
| |
Keywords: | everolimus metastatic renal cell carcinoma overall survival prognostic second-line targeted therapy tyrosine kinase inhibitor |
|
|