Categories of response to first line vascular endothelial growth factor receptor targeted therapy and overall survival in patients with metastatic renal cell carcinoma |
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| Affiliation: | 1. Charité University Medicine Berlin, Department of Urology, Berlin, Germany;2. University Medical Center Eppendorf, Department of Oncology/Hematology/Bone Marrow Transplantation/Pneumology, Hamburg, Germany;3. Clinic for Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany;4. Humboldt Vivantes Hospital Berlin, Department of Urology, Berlin, Germany;1. Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands;2. William Buckland Radiation Oncology, Alfred Health, Melbourne, Australia;1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea;2. Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea;1. Department of Otolaryngology and Head & Neck Surgery, Navy General Hospital, Beijing, China;2. Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA;3. Duke Cancer Institute, Duke University Medical Center, 905 South Lasalle Street, Durham, NC 27710, USA;4. Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA;1. Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan;1. Institute for Drug Development, Cancer Therapy and Research Center (CTRC), University of Texas Health Science Center, San Antonio, TX;2. Department of Epidemiology and Biostatistics, University of Texas Health Science Center, San Antonio, TX;1. Centre Hospitalier Régional Universitaire de Besançon, Université de Franche-Comté, EA 3181, France;2. Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France;3. Centre Hospitalier Universitaire de Caen, Université de Caen, Basse-Normandie, France;4. Centre Hospitalier Tenon, Hôpitaux de Paris, France |
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| Abstract: | IntroductionSequential use of targeted therapy (TT) has improved overall survival (OS) of patients with metastatic renal cell carcinoma (mRCC). The value of objective response (OR) as compared to stable disease (SD) is unclear. We aimed to investigate OR of first-line TT and its impact on OS.Material and methodsRetrospective analysis of OS among 331 mRCC patients with a first-line assessment according to RECIST 1.0. Characteristics between objective responders (complete response [CR] or partial remission [PR]), patients with SD and non-responders (progressive disease [PD] and toxicity [Tox]) were compared with the Chi-square test and the Kruskal–Wallis test. Kaplan–Meier analysis of OS and progression-free survival (PFS). Cox model analysis of Predictors of OS .ResultsBest response was CR, PR, SD, PD and Tox in 9 (2.7%), 61 (18.4%), 167 (50.5%), 80 (24.2%) and 14 (4.2%) patients respectively resulting in an OR rate of 21%. Median OS in months: CR 63.2; PR 37.6; SD 35.9; PD 14.6; TOX 22.5 (p < 0.0001). Median PFS for responders was 14.8, 11.5 for patients with SD and 2.5 for non-responders (p < 0.0001). Similarly median OS was 38.7, 35.9 and 15.5 (p < 0.00001). Primary resistance and a first-line PFS <6 months were the strongest independent predictors of OS. The achievement of OR as compared to SD did not impact OS.ConclusionsIn our cohort of unselected patients OR was not associated with superior OS as compared to SD. |
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| Keywords: | Renal cell carcinoma Metastasis Targeted therapy Objective response rate Overall survival |
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