Brain Metastases in Patients With Renal Cell Cancer Receiving New Targeted Treatment

Helgason, Helgi H.; Mallo, Henk; Droogendijk, Helga J.; Haanen, J.; Veldt, Astrid A.M. van der; Eertwegh, A.J. van den; Boven, Epie

doi:10.1200/jco.2007.13.5814

Cited by 41 publications

(26 citation statements)

References 14 publications

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“…Data regarding the administration of tyrosine kinase inhibitors such as sorafenib or sunitinib are very limited and quite controversial. A few small studies suggested a benefit for the control of brain metastases from RCC, whereas other authors concluded that tyrosine kinase inhibitors are inadequate for control of brain metastases from RCC and may even temporarily mask their existence (20)(21)(22)(23). Furthermore, the administration of tyrosine kinase inhibitors may lead to intreacerebral hemorrhage (23).…”

Section: Discussionmentioning

confidence: 95%

Do Patients Receiving Whole-Brain Radiotherapy for Brain Metastases From Renal Cell Carcinoma Benefit From Escalation of the Radiation Dose?

Rades

Heisterkamp

Schild

2010

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 95%

Do Patients Receiving Whole-Brain Radiotherapy for Brain Metastases From Renal Cell Carcinoma Benefit From Escalation of the Radiation Dose?

Rades

Heisterkamp

Schild

2010

International Journal of Radiation Oncology*Biology*Physics

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“…Primary tumours were also excluded, as the overall response may be underestimated due to their enormous size (Van der Veldt et al, 2008b;Bex et al, 2009). Furthermore, brain (Helgason et al, 2008) and bone metastases at baseline were excluded.…”

Section: Image Analysismentioning

confidence: 99%

Choi response criteria for early prediction of clinical outcome in patients with metastatic renal cell cancer treated with sunitinib

et al. 2010

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Background: Because sunitinib can induce extensive necrosis in metastatic renal cell cancer (mRCC), we examined whether criteria defined by Choi might be valuable to predict early sunitinib efficacy. Methods: Computed tomography was used for measurement of tumour lesions in mm and lesion attenuation in Hounsfield units (HUs). According to Choi criteria partial response (PR) was defined as ⩾10% decrease in size or ⩾15% decrease in attenuation. Results: A total of 55 mRCC patients treated with sunitinib were included. At first evaluation, according to the Response Evaluation Criteria in Solid Tumours (RECIST) 7 patients had PR, 38 stable disease (SD), and 10 progressive disease (PD), whereas according to Choi criteria 36 patients had PR, 6 SD and 13 PD. Median tumour attenuation decreased from 66 to 47 HUs ( P ⩽0.001). In patients with PR, Choi criteria had a significantly better predictive value for progression-free survival and overall survival (both P s<0.001) than RECIST ( P =0.685 and 0.191 respectively). The predictive value for RECIST increased ( P =0.001 and <0.001 respectively), when best response during treatment was taken into account. Conclusion: Choi criteria could be helpful to define early mRCC patients who benefit from sunitinib, but the use of these criteria will not change the management of these patients.

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“…No objective responses were observed in these subgroups. Seven patients developed symptomatic brain metastases as first or only sign of PD (Helgason et al, 2008).…”

Section: Efficacymentioning

confidence: 99%

Predictive factors for severe toxicity of sunitinib in unselected patients with advanced renal cell cancer

et al. 2008

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Sunitinib has been registered for the treatment of advanced renal cell cancer (RCC). As patient inclusion was highly selective in previous studies, experience with sunitinib in general oncological practice remains to be reported. We determined the efficacy and safety of sunitinib in patients with advanced RCC included in an expanded access programme. ECOG performance status 41, histology other than clear cell and presence of brain metastases were no exclusion criteria. Eighty-two patients were treated: 23% reached a partial response, 50% had stable disease, 20% progressed and six patients were not evaluable. Median progression-free survival (PFS) was 9 months and median overall survival (OS) was 15 months. Importantly, 47 patients (57%) needed a dose reduction, 35 (43%) because of treatment-related adverse events, 10 (12%) because of continuous dosing, and two because of both. Stomatitis, fatigue, hand -foot syndrome and a combination of grade 1 -2 adverse events were the most frequent reasons for dose reduction. In 40 patients (49%), there was severe toxicity, defined as dose reduction or permanent discontinuation, which was highly correlated with low body surface area, high age and female gender. On the basis of age and gender, a model was developed that could predict the probability of severe toxicity.

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Brain Metastases in Patients With Renal Cell Cancer Receiving New Targeted Treatment

Cited by 41 publications

References 14 publications

Do Patients Receiving Whole-Brain Radiotherapy for Brain Metastases From Renal Cell Carcinoma Benefit From Escalation of the Radiation Dose?

Do Patients Receiving Whole-Brain Radiotherapy for Brain Metastases From Renal Cell Carcinoma Benefit From Escalation of the Radiation Dose?

Choi response criteria for early prediction of clinical outcome in patients with metastatic renal cell cancer treated with sunitinib

Predictive factors for severe toxicity of sunitinib in unselected patients with advanced renal cell cancer

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