Efficacy of fourth-line targeted therapy in patients with metastatic renal cell carcinoma: a retrospective analysis

Ralla, Bernhard; Erber, Barbara; Goranova, Irena; Aue, Luise von der; Floercken, A.; Hinz, Stefan; Kempkensteffen, Carsten; Magheli, Ahmed; Miller, Kurt; Busch, Jonas

doi:10.1007/s00345-015-1740-z

Cited by 7 publications

(11 citation statements)

References 25 publications

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“…Median OS from initiation of any 4LT was 12.8 months, while the median PFS from initiation of any 4LT was 4.4 months. The 4LT survival data is comparable to a small (N = 56) fourth-line retrospective study, which displayed an OS and PFS of 10.5 and 3.2 months, respectively [8]. Moreover, the ORR of 13.7% is comparable to that of two small German retrospective studies, which displayed ORRs of 8.9% and 16.7% [8,10].…”

Section: Discussionsupporting

confidence: 74%

“…Thus, the fourth-line setting has not been studied extensively. Furthermore, only a handful of retrospective studies have looked at small cohorts of patients receiving 4LT, with many of these including cytokine immunotherapy as a previous line of treatment [8][9][10][11]. As a result, no clear guidelines exist to guide clinicians in the fourth-line setting.…”

Section: Discussionmentioning

confidence: 99%

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Fourth-Line Therapy in Metastatic Renal Cell Carcinoma (mRCC): Results from the International mRCC Database Consortium (IMDC)1

Stukalin

Wells

Fraccon

et al. 2018

KCA

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Abstract.Background: Fourth-line therapy (4LT) in the treatment of metastatic renal cell carcinoma (mRCC) varies significantly due to the lack of data and recommendations to guide treatment decisions. Objective: To evaluate the use and efficacy of 4LT in mRCC patients. Methods: The International mRCC Database Consortium (IMDC) dataset was used to identify patients with mRCC treated with 4LT. This is a multicenter, retrospective cohort study. Overall survival (OS) and progression-free survival (PFS) were calculated using Kaplan-Meier curves. Patients were evaluated for overall response. The six prognostic variables included in Conclusions: 4LT use appears to have activity in mRCC patients. The IMDC continues to be of prognostic value in the fourth-line setting for OS. This study helps to set a benchmark for response rate and survival for which clinical trials can plan sample size calculations and aim to improve upon.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Fourth-Line Therapy in Metastatic Renal Cell Carcinoma (mRCC): Results from the International mRCC Database Consortium (IMDC)1

Stukalin

Wells

Fraccon

et al. 2018

KCA

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“…Furthermore, no prospective trials and few retrospective analyses have been published concerning fourth-line therapy. [ 10 13 ] For this reason, fourth-line therapy is necessarily empirically administered. Furthermore, since those studies were mainly conducted in the US and Europe, only a little information about third- or fourth-line targeted therapy for Asian patients is available at present.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of third- and fourth-line targeted therapy in japanese patients with metastatic renal cell carcinoma: A retrospective analysis

et al. 2018

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Introduction:There is limited data on the efficacy of sequential targeted therapy for metastatic renal cell carcinoma (mRCC) beyond the second line, especially for Asian patients. We evaluated the efficacy and side effects of targeted therapy beyond the second line.Materials and Methods:We retrospectively reviewed 69 patients who were administered targeted therapy for mRCC at our institution between 2008 and 2016. Sunitinib, pazopanib, sorafenib, axitinib, everolimus, and temsirolimus were available in Japan in 2016, and treatment had been conducted with those six agents. Twenty-four patients underwent therapy beyond the second line. The progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. In addition, a survey on patients’ attitudes toward cancer treatment was conducted. Twenty-five of the 69 patients responded to the question with their opinions on the continuation of treatment after standard therapy failure.Results:The median PFS was 7.6 and 2.5 months for third- and fourth-line therapy. The median OS calculated from the initiation of third-line therapy was 14.2 months. The rates of serious toxicities with third- and fourth-line regimens were not markedly increased compared with first- and second-line therapies. Forty percent of patients hoped to continue treatment after exhausting standard care.Conclusions:Our retrospective study indicates the efficacy and safety of third- and fourth-line targeted therapies. In addition to the efficacy, a patient can also influence treatment continuation.

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“…This procedure prolongs the OS [133,134]. The benefits of fourth and subsequent lines of treatment are limited [135][136][137] and should only be considered in selected patients. The choice of the appropriate therapeutic strategy depends on the clinical situation and the type and tolerability of previous treatment.…”

Section: Third-line Treatment For Patients With Clear Cell Rccmentioning

confidence: 99%

Zalecenia Postępowania Diagnostyczno-Terapeutycznego W Raku Nerkowokomórkowym

et al. 2021

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Efficacy of fourth-line targeted therapy in patients with metastatic renal cell carcinoma: a retrospective analysis

Abstract: Patients might benefit from subsequent treatment lines independently from treatment response in first line.

Cited by 7 publications

References 25 publications

Fourth-Line Therapy in Metastatic Renal Cell Carcinoma (mRCC): Results from the International mRCC Database Consortium (IMDC)1

Fourth-Line Therapy in Metastatic Renal Cell Carcinoma (mRCC): Results from the International mRCC Database Consortium (IMDC)1

Efficacy and safety of third- and fourth-line targeted therapy in japanese patients with metastatic renal cell carcinoma: A retrospective analysis

Zalecenia Postępowania Diagnostyczno-Terapeutycznego W Raku Nerkowokomórkowym

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