Outcome of treatment discontinuation in patients with metastatic renal cell carcinoma and no evidence of disease following targeted therapy with or without metastasectomy

Johannsen, Manfred; Staehler, Michael; Ohlmann, C.; Flörcken, Anne; Schmittel, Alexander; Otto, T.; Bex, Axel; Hein, Patrick A.; Miller, Kurt; Weikert, Steffen; Grünwald, Viktor

doi:10.1093/annonc/mdq437

Cited by 48 publications

(34 citation statements)

References 21 publications

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“…21 Similar to our study, factors correlating with treatment outcome could not be identified in univariate and multivariate analyses. 21 In patients experiencing recurrence, targeted therapy was readministered in 23 patients; 18 patients received the same therapy, and five patients were switched to an alternative agent. In the patients receiving targeted therapy, one patient achieved CR, eight patients achieved PR, and 11 patients had SD.…”

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

“…19,21 A recent retrospective series of 36 patients who discontinued targeted therapy after CR or no evidence of disease showed that 24 patients (66.7%) experienced disease recurrence after a median follow-up of 12 months after discontinuation of therapy. 21 Similar to our study, factors correlating with treatment outcome could not be identified in univariate and multivariate analyses. 21 In patients experiencing recurrence, targeted therapy was readministered in 23 patients; 18 patients received the same therapy, and five patients were switched to an alternative agent.…”

Section: Discussionmentioning

confidence: 99%

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Complete Remission With Tyrosine Kinase Inhibitors in Renal Cell Carcinoma

Albigès

Oudard

Négrier

et al. 2012

JCO

150

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Purpose Complete remission (CR) is uncommon during treatment for metastatic renal cell carcinoma (mRCC) with tyrosine kinase inhibitors (TKIs), but it may occur in some patients. It remains a matter of debate whether therapy should be continued after CR. Methods A multicenter, retrospective analysis of a series of patients with mRCC who obtained CR during treatment with TKIs (sunitinib or sorafenib), either alone or with local treatment (surgery, radiotherapy, or radiofrequency ablation), was performed. Results CR was identified in 64 patients; 36 patients had received TKI treatment alone and 28 had also received local treatment. Most patients had clear cell histology (60 of 64 patients), and all had undergone previous nephrectomy. The majority of patients were favorable or intermediate risk; however, three patients were poor risk. Most patients developed CR during sunitinib treatment (59 of 64 patients). Among the 36 patients who achieved CR with TKI alone, eight continued TKI treatment after CR, whereas 28 stopped treatment. Seventeen patients who stopped treatment (61%) are still in CR, with a median follow-up of 255 days. Among the 28 patients in CR after TKI plus local treatment, 25 patients stopped treatment, and 12 of these patients (48%) are still in CR, with a median follow-up of 322 days. Conclusion CR can occur after TKI treatment alone or when combined with local treatment. CR was observed at every metastatic site and in every prognostic group.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Complete Remission With Tyrosine Kinase Inhibitors in Renal Cell Carcinoma

Albigès

Oudard

Négrier

et al. 2012

JCO

150

View full text Add to dashboard Cite

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“…and combining surgery, there are large series of patients with mRCC achieving CR during TKIs treatment, whereas agents of TKIs are mainly sunitinib. 11,12 One series included 36 patients who achieved CR during TKI treatment; in this series, 12 patients (33%) remained recurrence free at the 12-month median follow-up. 11 In another series, 64 patients achieved CR during TKI treatment.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 One series included 36 patients who achieved CR during TKI treatment; in this series, 12 patients (33%) remained recurrence free at the 12-month median follow-up. 11 In another series, 64 patients achieved CR during TKI treatment. Of the total 64 patients, 29 remained recurrence free at 8.5 months (or 255 days).…”

Section: Discussionmentioning

confidence: 99%

Complete response to low-dose sorafenib in a patient with metastatic renal cell carcinoma: A case report

Murata

Naoe

Ogawa

et al. 2013

CUAJ

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We present a case of a patient with metastatic renal cell carcinoma (mRCC) who was treated solely with low-dose sorafenib and achieved a complete response (CR). A 79-year-old man with cytokine-refractory mRCC involving the lung, abdominal wall and lymph nodes was treated with low-dose sorafenib (400 mg/day) as a second-line therapy. Five months into treatment, CR was confirmed by follow-up computed tomography. No severe adverse events were observed and sorafenib treatment was continued without appearance of new lesions. Although sorafenib has been approved for mRCC treatment, complete clinical recovery is uncommon and has rarely been described. In this case, low-dose sorafenib appears to be sufficient for achieving CR while suppressing toxicity. Furthermore, long-term continuous administration induces the patient to obtain disease stabilization. However, considering toxicity and treatment costs, it is debatable whether treatment should be discontinued or sustained after CR.

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