Outcomes for Patients with Metastatic Renal Cell Carcinoma Achieving a Complete Response on Targeted Therapy: A Registry-based Analysis
Language English Country Switzerland Media print-electronic
Document type Journal Article
PubMed
26746623
DOI
10.1016/j.eururo.2015.12.031
PII: S0302-2838(15)01240-3
Knihovny.cz E-resources
- Keywords
- Complete response, Renal cell carcinoma, Survival, Targeted therapy,
- MeSH
- Bevacizumab therapeutic use MeSH
- Molecular Targeted Therapy MeSH
- Phenylurea Compounds therapeutic use MeSH
- Indazoles MeSH
- Indoles therapeutic use MeSH
- Carcinoma, Renal Cell drug therapy secondary MeSH
- Response Evaluation Criteria in Solid Tumors MeSH
- Middle Aged MeSH
- Humans MeSH
- Lymphatic Metastasis MeSH
- Survival Rate MeSH
- Kidney Neoplasms drug therapy pathology MeSH
- Lung Neoplasms drug therapy secondary MeSH
- Withholding Treatment MeSH
- Niacinamide analogs & derivatives therapeutic use MeSH
- Disease-Free Survival MeSH
- Antineoplastic Agents therapeutic use MeSH
- Pyrimidines therapeutic use MeSH
- Pyrroles therapeutic use MeSH
- Receptors, Vascular Endothelial Growth Factor antagonists & inhibitors MeSH
- Registries MeSH
- Aged MeSH
- Sorafenib MeSH
- Sulfonamides therapeutic use MeSH
- Sunitinib MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Bevacizumab MeSH
- Phenylurea Compounds MeSH
- Indazoles MeSH
- Indoles MeSH
- Niacinamide MeSH
- pazopanib MeSH Browser
- Antineoplastic Agents MeSH
- Pyrimidines MeSH
- Pyrroles MeSH
- Receptors, Vascular Endothelial Growth Factor MeSH
- Sorafenib MeSH
- Sulfonamides MeSH
- Sunitinib MeSH
BACKGROUND: It is currently not known whether treatment with anti-vascular endothelial growth factor agents for metastatic renal cell carcinoma (mRCC) can be safely discontinued in patients achieving a complete response (CR). OBJECTIVE: To assess outcomes for patients with mRCC achieving CR on targeted therapy (TT) and the survival of patients discontinuing TT after CR. DESIGN, SETTING, AND PARTICIPANTS: A national registry was used to identify patients achieving CR during first-line TT using bevacizumab, sunitinib, sorafenib, or pazopanib. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Relationships with outcomes were analysed using a log-rank test. RESULTS AND LIMITATIONS: A total of 100 patients achieving CR were identified out of 2803 patients. The median time to CR was 10.1 mo. Median progression-free survival (PFS) from TT initiation was 3.8 yr (95% confidence interval [CI] 2.9-4.6 yr) and the 5-yr overall survival (OS) was 80% (95% CI 70-91%). Patients discontinuing TT within 1 mo after achieving CR and those continuing TT beyond CR had similar OS (CI for difference in 2-yr post-CR OS -13% to 19%; p=0.3) and PFS (CI for difference in 2-yr post-CR PFS -29% to 17%; p=0.7). The limitations include the retrospective, registry-based data analysis. CONCLUSIONS: Achievement of CR on TT for mRCC was associated with excellent long-term prognosis. No significant differences in post-CR survival were observed between patients discontinuing TT after the date of CR and those who continued on TT, although the wide CIs cannot exclude important differences between the groups. PATIENT SUMMARY: According to this registry-based analysis, patients with metastatic renal cancer with no signs of disease (complete response) after treatment with targeted agents experience excellent long-term survival even if the treatment does not continue beyond the date of complete response.
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 Faculty of Medicine Masaryk University Brno Czech Republic
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