Do cytokines improve survival in patients with metastatic renal cell carcinoma (MRCC) of intermediate prognosis? Results of the prospective randomized PERCY Quattro trial

Négrier, S.; Pérol, David; Ravaud, Alain; Chevreau, Christine; Bay, Jacques Olivier; Delva, R.; Sevin, Emmanuel; Caty, Armelle; Tubiana-Mathieu, Nicole; Escudier, Bernard

doi:10.1200/jco.2005.23.16_suppl.lba4511

Cited by 68 publications

(30 citation statements)

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“…20 One-year survival data were reported in 2 trials 18,19,21 and extracted from survival curves in 4 trials. [10][11][12]16,20,22 Two trials did not report survival outcomes. 15,17 Disease progression was assessed in 3 trials.…”

Section: Discussionmentioning

confidence: 99%

“…When the HR and its associated variance were available, those statistics were either extracted directly from the trial itself, from the Cochrane meta-analysis 9 or were obtained through personal communication with trial authors. Otherwise, the HR was estimated indirectly from data extracted from published KaplanMeier curves, [10][11][12] using the methods of Parmar and colleagues. 13 If data were not provided from which the HR could be derived or the authors did not provide the HR, the trial was not included in the meta-analysis.…”

Section: Synthesizing the Evidencementioning

confidence: 99%

“…[10][11][12][15][16][17][18][19][20][21][22] The trials included 1360 patients, with patient accrual per trial arm ranging from 16 to 176. Patients were eligible for inclusion if they had histologically confirmed RCC and showed no signs of brain metastases.…”

Section: Randomized Controlled Trialsmentioning

confidence: 99%

“…Two studies did not report the number of patients randomized per group. 15,16 In addition, there were inconsistencies within a report regarding the number of patients reported, treated and randomized; [10][11][12]16,18,19 in some cases, different publications of the same trial reported a different number of patients randomized. Some of these issues were resolved through personal correspondence either with the study authors or with the author of the Cochrane months.…”

Section: Trial Qualitymentioning

confidence: 99%

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Interferon-alfa in the treatment of patients with inoperable locally advanced or metastatic renal cell carcinoma: a systematic review

Canil

Hotte

Mayhew

et al. 2013

CUAJ

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A systematic review was undertaken to determine whether interferon-alfa (IFN-α) is an effective treatment for patients with inoperable locally advanced or metastatic renal cell carcinoma (mRCC). MEDLINE, EMBASE, the Cochrane Library, guideline databases and relevant meeting proceedings were searched. Randomized clinical trials (RCTs) or meta-analyses comparing IFN-α-containing regimens to placebo or non-immunotherapy controls, and that reported response rate, survival, toxicity or quality of life data were eligible. Two systematic reviews and eight RCTs met the selection criteria. A Cochrane review updated in 2005 reported higher response rates and reduced one-year mortality based on 4 RCTs in patients who received IFN-α. Of the eight RCTs, three reporting objective response rate showed significant differences favouring IFN-α. Two of five trials reporting survival data showed longer median survival in the IFN-α group. Adverse effects of IFN-α were consistent across the trials with increased intensity and frequency concordant with increased IFN-α dose. Meta-analyses of seven RCTs for objective response and six RCTs for mortality favoured IFN-α: odds ratio 6.87 (95% Confidence Interval [CI], 3.29 to 14.35) and hazard ratio 0.79 (95% CI, 0.69 to 0.91), respectively. The effectiveness of IFN-α in mRCC has been subject to skepticism. As IFN-α has been used as a control arm in RCTs of new targeted therapies, therapies which not all patients may have access to, information about its effectiveness remains relevant. These data confirm genuine, if modest, effectiveness of IFN-α in mRCC. RésuméUne revue systématique a été entreprise afin de déterminer si l'interféron alpha (IFN-α) représente un traitement efficace chez les patients atteints d'un hypernéphrome localement avancé ou métas-tatique et non opérable. Des recherches ont été effectuées dans les bases de données MEDLINE et EMBASE, dans la Bibliothèque Cochrane, les guides de pratique et les comptes rendus des réu-nions pertinentes. Les essais cliniques avec randomisation (ECR) ou les méta-analyses comparant des schémas contenant l'IFN-α à un placebo ou à un traitement témoin autre qu'une immunothérapie et qui faisaient état du taux de réponse, du taux de survie, des données sur la toxicité ou la qualité de vie pouvaient être inclus. Comme l'IFN-α a été utilisé comme traitement témoin dans des ECR portant sur de nouveaux traitements ciblés, auxquels tous les patients n'ont pas nécessairement accès, les renseignements concernant son efficacité conservent toute leur pertinence. Ces données confirment l'efficacité réelle, quoique modeste, de l'IFN-α dans le traitement de l'hypernéphrome métastatique.

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Section: Discussionmentioning

confidence: 99%

Section: Synthesizing the Evidencementioning

confidence: 99%

Section: Randomized Controlled Trialsmentioning

confidence: 99%

Section: Trial Qualitymentioning

confidence: 99%

See 2 more Smart Citations

Interferon-alfa in the treatment of patients with inoperable locally advanced or metastatic renal cell carcinoma: a systematic review

Canil

Hotte

Mayhew

et al. 2013

CUAJ

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“…1 Although high-dose interleukin (IL)-2 consistently produces a 15% to 20% response rate (RR), a 7% to 8% complete remission (CR) rate, and an approximately 6% cure rate in selected patients, its use has been limited on the basis of patient age, performance status, and organ function. 2,3 Interferon-a (IFN-a) provides a modest survival benefit in patients with MRCC, 4,5 although recent data from Negrier et al 6 have challenged this view, at least for patients with intermediate-risk MRCC. Because of its straightforward outpatient administration and favorable toxicity profile compared with high-dose IL-2, IFN-a has been adopted as the control arm in clinical trials of novel agents in MRCC.…”

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confidence: 99%

Improved tolerability and quality of life with maintained efficacy using twice‐daily low‐dose interferon‐α‐2b

Tannir

Cohen

Wang

et al. 2006

Cancer

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The global obesity epidemic remains poorly understood, partly because it has emerged alongside persisting under‐nutrition in many populations. At an abstract level, obesity develops from exposure to the “obesogenic niche,” comprising diverse factors predisposing to weight gain. This article first explores how susceptibility to the obesogenic niche is influenced by developmental and life‐history experience. Human growth is sensitive to early‐life ecological conditions, under the transducing effect of maternal phenotype. Such plasticity is associated with subsequent variability in body composition and metabolism, impacting susceptibility to the obesogenic niche, albeit with heterogeneity across populations. Both nutritional constraint and nutritional excess during early life are associated with variability in relevant molecular pathways. The article then considers the fundamental contribution of capitalist economics to population under‐nutrition and over‐nutrition. Historically, capitalism contributed to the under‐nutrition of many populations through demand for cheap labor. As the limiting factor for economic growth switched to consumption, capitalism has increasingly driven consumer behavior inducing widespread over‐nutrition. In populations undergoing nutritional transition, many individuals encounter both under‐ and over‐nutrition within the life course, elevating both susceptibility and exposure to the obesogenic niche. The interactions between global economic forces and nutritional shifts are distributed across generations, and are strongly transduced by maternal effects. The structural connections between undernourished and overnourished worldwide and between under‐ and over‐nutrition within individual life‐courses highlight the central role of capitalist economics in the global obesity epidemic. Prevention policies targeting individual behavior have proved ineffective and economic policies are arguably the optimal target for intervention. Am. J. Hum. Biol. 2012. © 2012 Wiley Periodicals, Inc.

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Treatment of patients with metastatic renal cell cancer

Halbert

Figlin

Atkins

et al. 2006

Cancer

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BACKGROUND.New developments in the treatment of patients with metastatic renal cell cancer (MRCC) have suggested a need to reevaluate the role of systemic therapies. The authors convened a panel of medical and urologic oncologists to rate the appropriateness of the main options.METHODS.The authors used the RAND/University of California‐Los Angeles Appropriateness Method to evaluate systemic therapy options and cytoreductive nephrectomy. After a comprehensive literature review, an expert panel rated the appropriateness of systemic options (108 permutations) and cytoreductive nephrectomy (24 permutations) for patients with MRCC.RESULTS.The appropriateness evaluation indicated that 27.3% of permutations were rated “appropriate,” 46.9% were rated “inappropriate,” and 25.8% were rated “uncertain.” There was a high rate of agreement (95%). Sunitinib and sorafenib were rated appropriate for patients with low‐to‐moderate risk regardless of prior treatment. Temsirolimus was rated appropriate for first‐line therapy for higher risk patients. Interferon‐α and low‐dose interleukin‐2 were rated inappropriate or uncertain. In patients who received prior immunotherapy, cytokines were rated inappropriate. In all permutations for evaluating systemic therapy, enrollment into an investigational trial was considered appropriate, treatment with bevacizumab was uncertain, and thalidomide was inappropriate regardless of risk status or prior therapy. For good surgical risk patients with planned immunotherapy, nephrectomy was rated appropriate in patients who had limited metastatic burden regardless of tumor‐related symptoms and in symptomatic patients regardless of metastatic burden. Only the most favorable combination of surgical risk, metastatic burden, and symptoms generated an “appropriate” rating for patients with planned targeted therapy.CONCLUSIONS.The current results begin the process of defining an appropriate role for cytokines, newer targeted therapies, and surgery in the treatment of MRCC. Cancer 2006. © 2006 American Cancer Society.

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Do cytokines improve survival in patients with metastatic renal cell carcinoma (MRCC) of intermediate prognosis? Results of the prospective randomized PERCY Quattro trial

Cited by 68 publications

References 0 publications

Interferon-alfa in the treatment of patients with inoperable locally advanced or metastatic renal cell carcinoma: a systematic review

Interferon-alfa in the treatment of patients with inoperable locally advanced or metastatic renal cell carcinoma: a systematic review

Improved tolerability and quality of life with maintained efficacy using twice‐daily low‐dose interferon‐α‐2b

Treatment of patients with metastatic renal cell cancer

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