Efficacy of targeted treatment beyond third-line therapy in metastatic kidney cancer

• Verfasst von: Vallet, Sonia [VerfasserIn]
• Verfasst von: Pahernik, Sascha [VerfasserIn]
• Verfasst von: Tosev, Georgi [VerfasserIn]
• Verfasst von: Hadaschik, Boris [VerfasserIn]
• Verfasst von: Duensing, Stefan [VerfasserIn]
• Verfasst von: Sedlaczek, Oliver [VerfasserIn]
• Verfasst von: Hohenfellner, Markus [VerfasserIn]
• Verfasst von: Jäger, Dirk [VerfasserIn]
• Verfasst von: Grüllich, Carsten [VerfasserIn]
• Titel: Efficacy of targeted treatment beyond third-line therapy in metastatic kidney cancer
• Titelzusatz: retrospective analysis from a large-volume cancer center
• Verf.angabe: Sonia Vallet, Sascha Pahernik, Thomas Höfner, Georgi Tosev, Boris Hadaschik, Stefan Duensing, Oliver Sedlaczek, Markus Hohenfellner, Dirk Jäger, Carsten Grüllich
• Jahr: 2015
• Jahr des Originals: 2014
• Umfang: 8 S.
• Fussnoten: Published online: 30 December 2014 ; Gesehen am 08.06.2017
• Titel Quelle: Enthalten in: Clinical genitourinary cancer
• Ort Quelle: Dallas, Tex. : CIG Media Group, 2005
• Jahr Quelle: 2015
• Band/Heft Quelle: 13(2015), 3, Seite e145-e152
• ISSN Quelle: 1938-0682
• DOI: doi:10.1016/j.clgc.2014.12.012
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Metastatic kidney cancer
• Sach-SW: Multiple lines of treatment
• Sach-SW: Objective response
• Sach-SW: Survival
• Sach-SW: Targeted therapy
• K10plus-PPN: 1559578505

Abstract

Introduction/background, currently, 7 agents are approved for the first- and second-line therapy for metastatic renal cell carcinoma. In contrast, data supporting their use beyond second line are limited. Here we summarize our experience in patients treated with more than 4 lines of therapy. Methods: we retrospectively assessed the outcome of 24 patients treated at our institution with at least 4 lines of therapy. Progression-free survival (PFS) and overall survival (OS) were calculated using Kaplan-Meier estimates.Results: Median OS from the initiation of first-line therapy for the whole cohort is 64.7 months. Up to 96% of the patients received a tyrosine kinase inhibitor (TKI) and mammalian target of rapamycin (mTOR) inhibitor (mTOR-I) within the first 3 lines of treatment. In the fourth or following lines, patients were treated with TKI, mTOR-I, bevacizumab/interferon, or experimental drugs. Seven patients continued treatment with a sixth-line agent; one has been treated up to the ninth line. Sixteen percent of the patients receiving fourth-line therapy and 13% receiving fifth-line therapy experienced a partial remission, which was independent from response to previous therapies. Median OS from fourth and fifth line was 30.8 and 26.2 months, respectively. Median PFS for fourth-line therapy was 5.8 months. No significant difference in PFS was observed for patients with disease that responded or did not respond to first-line therapy. Conclusion: Despite the limitations of a retrospective analysis, our study suggests that selected patients benefit from multiple lines of treatment, independent of response to first-line therapy. However, the optimal sequence of treatment with regard to later lines remains to be determined.