To assess the efficacy and tolerability of rechallenge with sunitinib and other targeted therapies (TTs) in patitents with relapsed recurrent renal cell carcinoma (RCC) in the advanced setting. MethodsIn this multi-institutional retrospective study, patients with relapsed RCC were rechallenged with sunitinib or other systemic TTs as a first-line therapeutic approach after failed adjuvant sunitinib treatment. Patient characteristics, treatments and clinical outcomes were recorded. The primary endpoint was progression-free survival (PFS). Secondary endpoints were objective response rate (ORR) and overall survival (OS). ResultsA total of 34 patients with relapses were recorded, and 25 of these (73.5%) were men. Twenty-five patients were treated with systemic TT: 65% of patients received TT against the vascular endothelial growth factor pathway (including sunitinib), 21.7% received mammalian target of rapamycin inhibitors and 13% received immunotherapy. The median (interquartile range) time to relapse was 20.3 (5.2-20.4) months from diagnosis, and 7.5 months (1.0-8.5) from the end of adjuvant suntinib treatment. At a median follow-up of 23.5 months, 24 of the 25 patients had progressed on first-line systemic therapy. The median PFS was 12.0 months (95% confidence interval [CI] 5.78-18.2). There were no statistical differences in PFS between different treatments or sunitinib rechallenge. PFS was not statistically different in patients relapsing on or after adjuvant suntinib treatment (≤ 6 or >6 months after adjuvant suntinib ending). The ORR was 20.5%. The median OS was 29.1 months (95% CI 16.4-41.8). ConclusionsRechallenge with sunitinib or other systemic therapies is still a feasible therapeutic option that provides patients with advanced or metastastic RCC with additional clinical benefits with regard to PFS and OS after failed response to adjuvant sunitinib.
701 Background: There are no available data on the usefulness of targeted therapy (TT) as the first-line treatment for patients with RCC recurrence after AS. We aim to explore the outcomes of systemic therapy with recurrent RCC after AS including re-exposure to sunitinib. Methods: A multi-institutional retrospective study was conducted on RCC patients who relapsed after AS. The primary end point was progression-free survival (PFS). Secondary end points were overall response rate (ORR) and overall survival (OS). Results: 34 relapses were recorded, 25 patients (73,5%) were male. 25 patients were treated with systemic therapy at first-line after relapse: 65% of patients received Vascular Endothelial Growth Factor (VEGF)-TT (including 7 patients retreated with sunitinib), 21,7% mTOR inhibitors and 13% immunotherapy. The median time to relapse was 20,3 months (IQR 5,2-20,4) from diagnosis, and 7,5 months (IQR 1,0-8,5) months from AS ending. At a median time of follow-up of 23,5 months, 24/25 patients had progressed on first-line systemic therapy. The median PFS was 12,0 months (IC95% 6,6-17,8 months). There was no statistical difference in PFS among the different treatments or the re-exposed to sunitinib. PFS was not statistically different between those relapsing on or after AS ( < 6 or > 6 months after AS). ORR was 20,3%. Median OS was 28,7 months (IC95% 24,4-33,0). Conclusions: This study suggests that TT may still improve PFS and OS in RCC patients who relapsed after AS.
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