Although targeted therapies with inhibitors of the vascular endothelial growth factor (VEGF) are the mainstay of treatment for metastatic renal cell carcinoma, there are limited data on the outcome of patients with long-term response to this treatment.
In a retrospective, registry-based study, patients continuously treated with first-line anti-VEGF agents for at least 24 months were included. In total, 219 patients had evaluable data and were included in the outcome analysis.
Median progression-free survival (PFS) after initiation of first-line targeted therapy was 39.7 months (95% confidence interval [CI], 35.9-43.5 months), with 5-year PFS of 34.2% (95% CI, 27.2%-41.2%). Median overall survival (OS) reached 79.1 months (95% CI, 65.2-93.0 months) with the 5-year OS of 62.1% (95% CI, 54.5%-69.7%). In this cohort, 28, 103, and 88 patients achieved complete response (CR), partial response (PR), or stable disease (SD) as the best response, respectively. Median PFS and OS were comparable in patients with PR and SD, but significantly longer in patients with CR (log rank test P value for PFS difference < .001 and .009 for OS difference).
There are marked differences in PFS and OS between patients who receive long-term anti-VEGF treatment, achieving CR and non-CR as the best clinical response. Patients with non-CR experienced a relatively high progression rate shortly after the landmark time point of 2 years.
Clinical genitourinary cancer. 2017 Jun 29 [Epub ahead of print]
Tomas Buchler, Alexandr Poprach, Zbynek Bortlicek, Radek Lakomy, Renata Chloupková, Rostislav Vyzula, Milada Zemanova, Katerina Kopeckova, Marek Svoboda, Ondrej Slaby, Igor Kiss, Hana Studentova, Jana Hornova, Ondrej Fiala, Jindrich Kopecky, Jindrich Finek, Ladislav Dusek, Bohuslav Melichar, Czech Metastatic Renal Cancer Cooperative Group
Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Videnska, Prague, Czech Republic. Electronic address: ., Department of Comprehensive Cancer Care and Faculty of Medicine, Masaryk Memorial Cancer Institute and Masaryk University, Brno, Czech Republic., Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Department of Oncology, General University Hospital and Charles University First Faculty of Medicine, Prague, Czech Republic., Department of Oncology, Motol University Hospital and Second Faculty of Medicine, Charles University, Prague, Czech Republic., Department of Oncology, Palacky University Medical School and Teaching Hospital, Olomouc, Czech Republic., Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Videnska, Prague, Czech Republic., Department of Oncology, University Hospital, Pilsen, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic., University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic., Department of Oncology, University Hospital, Pilsen, Czech Republic.