Systemic Treatments for Metastatic Renal Cell Carcinoma: 10-Year Experience of Immunotherapy and Targeted Therapy

The purpose of this study is to compare the outcomes of first-line systemic targeted therapy (TT) and immunotherapy (IT) in patients with metastatic renal cell carcinoma (mRCC).

This study was a retrospective review of the data of 262 patients treated with systemic IT or TT with tyrosine kinase inhibitors between 2003 and 2013.

The objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were assessed using RECIST v1. 0 criteria and the Kaplan-Meier method with log-rank test.

During the median 4. 3-month treatment and the 24-month follow-up period, the ORR/PFS/OS of the overall first-line and second-line therapy were 41. 9%/8. 1months/16. 8months and 27. 5%/6. 5months/15. 3months, respectively. The first-line TT/IT/sequential IT had a PFS of 9. 3/6. 4/5. 7 months and an OS of 15. 8/16. 5/40. 6 months (all p < 0. 05). The second-line of TT/IT had a PFS of 7. 1/2. 1 months (both p < 0. 05) and an OS of 16. 6/8. 6 months (p = 0. 636), respectively. Pazopanib provided the best median PFS of 11. 0 months (p< 0. 001) and a quadruple IT regimen had a superior PFS (p= 0. 522). For OS, sequential treatment with IT and TT was superior compared to treatment with either IT or TT alone (40. 6/16. 5/15. 8 months; p=0. 014). The prognosis according to the MSKCC model showed that favorable/intermediate/poor risk groups had a PFS of 8. 5/10. 4/2. 3 months, and an OS of 43. 1/20. 4/5. 6 months, respectively. The prognosis calculated using the Heng model showed that the favorable/intermediate/poor risk groups had a PFS of 9. 2/3. 9/2. 7months, and an OS of 32. 4/16. 5/6. 1months, respectively (all p<0. 001).

In patients with mRCC, TT provided a better PFS and OS compared with IT.

Cancer research and treatment : official journal of Korean Cancer Association. 2016 Jan 28 [Epub ahead of print]

Sung Han Kim, Weon Seo Park, Sun Ho Kim, Jae Young Joung, Ho Kyung Seo, Kang Hyun Lee, Jinsoo Chung

Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.  

Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.

Department of Radiology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.

Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.

Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.

Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.

Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.

PubMed

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