Clinical impact of targeted therapies in patients with metastatic clear-cell renal cell carcinoma

Abstract

IntroductionThe aim of this retrospective clinical study was to assess, in the context of the recent evolution of systemic therapies, the potential effect of targeted therapies on overall survival (OS) of patients with metastatic clear-cell renal cell carcinoma (mccRCC) in daily practice.Patients and methodsAll consecutive patients with histologically confirmed mccRCC who received systemic therapy between January 2000 and December 2010 in two oncology treatment centers in our Franche-Comté region in eastern France were included in the analysis. The primary end point was OS. The analysis of prognostic factors was performed using a two-step approach: univariate then multivariate analysis with a stepwise Cox proportional hazards regression model.ResultsFor the entire cohort of 111 patients, the median OS was 17 months (95% confidence interval [CI]; 13–22 months) and the two-year OS was 39%. Three prognostic factors were independent predictors of long survival: prior nephrectomy (hazard ratio =0.38 [0.22–0.64], P<0.0001); systemic therapy by targeted therapy (hazard ratio =0.50 [0.31–0.80], P=0.005); and lack of liver metastasis (hazard ratio =0.43 [0.22–0.82], P=0.002). Median OS was 21 months [14–29 months] for patients who received at least one targeted therapy compared with 12 months [7–15 months] for patients who were treated only by immunotherapy agents (P=0.003).ConclusionOur results suggest that targeted therapies are associated with improved OS in comparison with cytokines, which is in line with other publications.

MicroRNA‑138 suppresses cell proliferation and invasion of renal cell carcinoma by directly targeting SOX9

“…RCC may be histologically classified into three subtypes, including clear cell RCC, papillary RCC and chromophobe RCC. Clear cell RCC is the most common of these subtypes, accounting for 75 to 80% of RCC cases, and also is the most aggressive (3)(4)(5). The standard curative treatment for patients with localized RCC is surgical excision with total nephrectomy.…”

miR-10b is a prognostic marker in clear cell renal cell carcinoma

“…About 33% of patients have metastatic disease at the time of diagnosis and another 20%–40% develop metastasis later in the course of the disease. In addition, RCC incidence increases constantly by about 1.5%–5.9% annually, and the cancer-specific mortality is about 40% in RCC 2 3…”

Extracellular vesicles isolated from human renal cell carcinoma tissues disrupt vascular endothelial cell morphology via azurocidin

“…The prognosis for early‐stage ccRCC is usually good, with a 5‐year survival rate of about 90%, however this rate drops to about 10% in ccRCC patients with metastasis. Large number of early‐stage ccRCC cases are asymptomatic, with approximately one‐third of all patients presenting with locally metastatic cancer at the time of diagnosis . Therefore, a better understanding of the molecular mechanisms of ccRCC progression is crucial for the discovery of novel prognostic markers and targeted therapies.…”

“…Large number of early-stage ccRCC cases are asymptomatic, with approximately one-third of all patients presenting with locally metastatic cancer at the time of diagnosis. 2,3 Therefore, a better understanding of the molecular mechanisms of ccRCC progression is crucial for the discovery of novel prognostic markers and targeted therapies.…”