Efficacy of everolimus in second- and third-line therapy for metastatic renal cell carcinoma: a registry-based analysis
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
24629497
DOI
10.1016/j.urolonc.2013.12.007
PII: S1078-1439(13)00509-7
Knihovny.cz E-resources
- Keywords
- Everolimus, Renal cell carcinoma, Therapy, Tyrosine kinase inhibitors, mTOR,
- MeSH
- Databases, Factual MeSH
- Adult MeSH
- Everolimus MeSH
- Drug Therapy methods MeSH
- Immunosuppressive Agents administration & dosage therapeutic use MeSH
- Protein Kinase Inhibitors therapeutic use MeSH
- Carcinoma, Renal Cell drug therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Metastasis MeSH
- Kidney Neoplasms drug therapy MeSH
- Disease-Free Survival MeSH
- Disease Progression MeSH
- Registries MeSH
- Retrospective Studies MeSH
- Drug Administration Schedule MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Sirolimus administration & dosage analogs & derivatives therapeutic use MeSH
- Protein-Tyrosine Kinases antagonists & inhibitors MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Everolimus MeSH
- Immunosuppressive Agents MeSH
- Protein Kinase Inhibitors MeSH
- Sirolimus MeSH
- Protein-Tyrosine Kinases MeSH
OBJECTIVES: The aim of the present study was to describe the efficacy and safety of everolimus in the treatment of metastatic renal cell carcinoma (mRCC) after administration of 1 vs. 2 prior tyrosine kinase inhibitors (TKIs). PATIENTS AND METHODS: A national renal information system database was used as the data source for the retrospective study. There were 483 patients who received everolimus as the second (n = 350) or the third (n = 112) targeted agent following TKIs. RESULTS: Median progression-free survival (PFS) from the start of everolimus in the second or the third line of targeted therapy was 6.1 months for both subgroups (P = 0.863). Median total PFS from the start of the first targeted agent to progression on the third targeted agent for patients receiving 3 lines of therapy with TKI-TKI-everolimus (n = 112) and TKI-everolimus-TKI (n = 27) sequences was 28.3 months vs. 31.3 months, respectively (P = 0.16), and there was no significant difference in overall survival. PFS on everolimus was associated with PFS on previous TKIs in patients receiving 1 but not 2 previous TKIs. Only 13% of 352 patients starting targeted therapy for mRCC in 2010 had received 3 sequential targeted agents by the data cutoff in March 2013. CONCLUSION: PFS on everolimus correlated with PFS on TKIs in patients pretreated with 1 but not 2 TKIs. Everolimus can be deferred to the third line without loss of efficacy or increased toxicity. However, only a minority of patients with mRCC starting targeted treatment can be expected to receive third-line therapy.
Department of Comprehensive Cancer Care Masaryk Memorial Cancer Institute Brno Czech Republic
Department of Oncology University Hospital Pilsen Czech Republic
Institute of Biostatistics and Analyses Masaryk University Brno Czech Republic
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