Locoregional treatment with radical intent should be considered during therapy with targeted agents in patients with metastatic renal cell carcinoma (mRCC) in order to achieve a complete response, especially in the setting of an oligo-progression in one or more metastatic sites. We retrospectively enrolled 55 patients who experienced a disease oligo-progression after at least 6 months from the beginning of first-line therapy in one or more metastatic sites radically treated with locoregional treatments. Post-first-oligo-progression overall survival (PFOPOS) and post-first-oligo-progression free survival (PFOPFS) were evaluated. The global median PFOPOS and PFOPFS were 37 months and 14 months respectively. Patients who continued the same therapy after a locoregional treatment on a site of progression had a significantly longer mPFOPOS compared to patients who changed therapy (39 vs 11 months, p=0.014). An advantage in mPFOPOS was also observed in patients with a Memorial Sloan-Kettering Cancer Center (MSKCC) good risk score compared to patients of the intermediate risk group (39 vs 29 months, p=0.036); patients with bone metastases had a longer mPFOPOS compared to those with visceral metastases (not reached vs 31 months, p=0.045). The only independent predictor of poor prognosis, in terms of PFOPOS at multivariate analysis (p=0.007), proved out to be change of treatment after first progression. In this paper we aim to illustrate that continuing the same systemic therapy, after a radical locoregional treatment on a site of progression, seems to be associated with a prolongation of mPFOPOS.
Oncotarget. 2017 Aug 07*** epublish ***
Daniele Santini, Raffaele Ratta, Francesco Pantano, Delia De Lisi, Marco Maruzzo, Luca Galli, Elisa Biasco, Azzurra Farnesi, Sebastiano Buti, Cora Nanette Sternberg, Linda Cerbone, Giuseppe Di Lorenzo, Silvia Spoto, Michelle Sterpi, Ugo De Giorgi, Rossana Berardi, Mariangela Torniai, Andrea Camerini, Francesco Massari, Giuseppe Procopio, Giuseppe Tonini
Campus Bio-Medico University of Rome, Department of Medical Oncology, Rome, Italy., Fondazione IRCCS, Istituto Nazionale dei Tumori, Oncology Unit 1, Milan, Italy., Istituto Oncologico Veneto, IOV-IRCCS, Medical Oncology 1 Unit, Padova, Italy., University Hospital of Pisa, Oncology Unit 2, Pisa, Italy., University Hospital of Parma, Medical Oncology, Parma, Italy., San Camillo and Forlanini Hospitals, Department of Medical Oncology, Rome, Italy., Department of Clinical Medicine & Surgery, Oncology Division, University Federico II, Naples, Italy., Campus Bio-Medico University of Rome, Department of Internal Medicine, Rome, Italy., IRCCS Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori, Department of Medical Oncology, Meldola, Italy., Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Medical Oncology Unit, Ancona, Italy., Versilia Hospital and Istituto Toscano Tumori, Medical Oncology, Lido di Camaiore, Italy., S.Orsola-Malpighi Hospital, Division of Oncology, Bologna, Italy.