Long-term stable disease in metastatic renal cell carcinoma: sorafenib sequenced to sunitinib and everolimus: a case study |
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Authors: | Joachim Beck Joaquim Bellmunt Bernard Escudier |
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Institution: | (1) Internal Department III, Johannes-Gutenberg-University, Langenbeckstr. 1, 55131 Mainz, Germany;(2) Department of Oncology, University Hospital del Mar-IMIM, 08003 Barcelona, Spain;(3) Department of Medicine, Institut Gustave Roussy, 94805 Villejuif, France |
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Abstract: | Long-term stabilization of advanced renal cell carcinoma (RCC) by the sequence of sorafenib monotherapy followed by sunitinib
and everolimus treatments in a man with multiple metastases is reported. A 66-year-old man was diagnosed with advanced RCC
in 2005. The patient initially underwent nephrectomy, but subsequently the disease metastasized to the lung, lymph nodes,
and pancreas. The patient received sorafenib 400 mg bid in a clinical trial. He experienced minimal and manageable adverse
events and achieved stable disease (SD), which was maintained with sorafenib therapy for nearly 3 years before the development
of liver metastases. The patient was then prescribed sunitinib, with which he also experienced SD for 1.2 years until disease
progression prompted the initiation of third-line everolimus therapy, resulting in SD for another 8 months. The patient lived
with stabilized RCC for 4.6 years with the use of these three sequential targeted therapies. First-line sorafenib monotherapy
achieved a durable stable response and subsequent use of sunitinib and then everolimus permitted a return to SD after disease
progression. The patient experienced minimal toxicity from the regimen, suggesting that it can be safely administered to elderly
patients. |
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