Survival outcomes for advanced kidney cancer patients in the era of targeted therapies

Rao, Arpit; Wiggins, Charles L.; Lauer, Richard C.

doi:10.21037/atm.2018.04.44

Cited by 43 publications

(44 citation statements)

References 13 publications

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“…Similar to the observations made in this study, an analysis of the Surveillance, Epidemiology, and End Results (SEER) database showed a 10% higher risk of mortality in women compared to men. 28 One of the reported risk factors associated with increased risk of mortality in women was relative visceral fat; women with relative visceral fat greater than 30.9% had an increased risk of death, 29 but because these data are not available for this study, a potential association would be speculative.…”

Section: Time To Progression (Months) Per Substance Progression-free mentioning

confidence: 92%

Real-World Evidence Data on Metastatic Renal-Cell Carcinoma Treatment in Austria: The RELACS Study

Schmidinger

Pichler

Loidl

et al. 2019

Clinical Genitourinary Cancer

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There is a significant need for real-world evidence that mirrors the outcome from established available treatments in terms of efficacy and safety in clinical practice. RELACS is a retrospective, noninterventional chart review of Austrian patients with renal-cell carcinoma, those receiving systemic treatment during 2010-2016 across 12 centers. This study showed much longer median overall survival than previous reports in realworld setting. Background: Treatment decisions in routine clinical practice are based on reports of clinical trials, which represent highly selected populations. Limited studies reported real-world evidences representing routine clinical practices in patients with renal-cell carcinoma (RCC) in Europe. The aim of this retrospective, noninterventional chart review was to collect data on the treatment landscape for patients with advanced/metastatic RCC in routine clinical practice in a broader patient population in Austria. Patients and Methods: Patients with advanced/metastatic RCC receiving systemic treatment between June 2010 and June 2016 across 12 centers in Austria were included. Parameters were entered into an electronic case report form from the participating sites via the application Hermesoft electronic data capture system. Progression-free survival (PFS) and overall survival (OS) were the 2 primary end points. Results: The median PFS and OS were 12 months and 44 months, respectively (first-line PFS was 14 months for pazopanib and 13 months for sunitinib; first-line OS was 44 months for pazopanib and 48 months for sunitinib). Factors influencing the OS were sex, with female patients at a significantly higher risk than male patients (hazard ratio ¼ 1.719), Eastern Cooperative Oncology Group performance status > 0 increased the risk twice (hazard ratio ¼ 2.048), and number of metastases > 3 before the first line doubled the risk compared to metastases (hazard ratio ¼ 2.064). Conclusion: OS in this retrospective chart review was considerably longer than the previous reports in real-world patients, underlining the benefit of current RCC treatment options in routine clinical practice.

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Section: Time To Progression (Months) Per Substance Progression-free mentioning

confidence: 92%

Real-World Evidence Data on Metastatic Renal-Cell Carcinoma Treatment in Austria: The RELACS Study

Schmidinger

Pichler

Loidl

et al. 2019

Clinical Genitourinary Cancer

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“…Анализ базы данных SEER с включением 14 976 пациентов показывает, что в США продолжительность жизни при распространенном раке почки с началом эпохи таргетной терапии (2007-2013 гг.) стала лучше на 13 % (P<0.0001) [23]. К сожалению, выраженной позитивной динамики в российской популяции не наблюдается.…”

Section: собственные исследованияunclassified

Life expectancy in patients with metastatic renal cell carcinoma in the Russian Federation: results of the RENSUR3 multicenter registry study

Тимофеев¹,

Varlamov²,

Петкау³

et al. 2019

Malignant Tumours

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Введение. Данные по общей выживаемости (ОВ) пациентов с метастатическим почечно-клеточным раком (мПКР) в реальной жизни публикуются редко. Задача регистрового исследования RENSUR3 заключалась в сборе сведений по применению разных вариантов терапии при мПКР в условиях реальной клинической практики и оценке ОВ в популяции российских пациентов. Методы. Пациентов ретроспективно идентифицировали в 8 онкологических центрах в разных регионах России и включали в исследование, если диагноз мПКР был установлен в период с января 2015 г. по декабрь 2016 г. Анонимные сведения собирали онлайн, регистр охватывал демографические характеристики, а также данные по терапии и исходам. Результаты. В исследование для анализа было включено 573 больных, 65,6 % из них составили мужчины. Средний возраст пациентов на момент постановки диагноза мПКР составил 63,1 года, при этом 14,5 % были в возрасте ≥75 лет. 72 % прошли хирургическое лечение по поводу первичной опухоли; светлоклеточный и несветлоклеточный рак был выявлен у 84 % и 16 % пациентов, соответственно. Лекарственная терапия проводилась 307 (54 %) пациентам. Медиана продолжительности всех линий терапии составила 10 месяцев (95 % ДИ 7,6-12,4). Наиболее часто применявшимся вариантом лечения было назначение интерферона (частота-161 раз в любой из линий или на различных этапах лечения). Таргетная терапия проводилась у 160 (52,1 %) пациентов, из них в качестве первой линии таргетную терапию получили 112 пациентов. 87 (28,3 %) больных получили ≥2 линий терапии. 3-летняя ОВ составила 21 %, а медиана ОВ-12 месяцев (95 % ДИ 11,1-12,9). Медиана ОВ в группах получивших и не получивших терапию пациентов составила 15,1 и 6,9 месяца, соответственно (Р<0,0001). Продолжительность жизни пациентов, прошедших вторую линию терапии (медиана-18,4 месяца), была значительно дольше, чем у пациентов, получивших только первую линию терапии (10,9 месяца, Р<0,001). Выводы. Показатели ОВ в исследовании RENSUR3 являются неудовлетворительными, что, по-видимому, можно объяснить назначением лекарственного лечения только половине пациентов, низкой частотой применения таргетных препаратов, редким назначением таргетной терапии во второй и последующих линиях при прогрессировании болезни. Внедрение новейших вариантов лекарственного лечения, в том числе ингибиторов контрольных точек, будет способствовать улучшению продолжительности жизни больных. ЗЛОКАЧЕСТВЕННЫЕ ОПУХОЛИ Российское общество клинической онкологии MALIGNANT TUMOURS Russian Society of Clinical Oncology том / vol. 9 № 2 • 2019 ЗЛОКАЧЕСТВЕННЫЕ ОПУХОЛИ Российское общество клинической онкологии MALIGNANT TUMOURS Russian Society of Clinical Oncology том / vol. 9 № 2 • 2019 ЗЛОКАЧЕСТВЕННЫЕ ОПУХОЛИ Российское общество клинической онкологии MALIGNANT TUMOURS Russian Society of Clinical Oncology том / vol. 9 № 2 • 2019 ЗЛОКАЧЕСТВЕННЫЕ ОПУХОЛИ Российское общество клинической онкологии MALIGNANT TUMOURS Russian Society of Clinical Oncology том / vol. 9 № 2 • 2019 Собственные исследования Results. The study had 573 subjects included in the analysis. The average age of p...

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“…Renal cell carcinoma (RCC) remains one of the most burdensome urological cancers, as its incidence is increasing worldwide 1 , and a considerable proportion of patients present with metastatic disease at diagnosis 2 . The oral multi-targeted receptor tyrosine-kinase inhibitors (TKIs) sunitinib and pazopanib have dramatically improved clinical outcomes of patients with metastatic RCC (mRCC) 3 , and are among the first-line options for this condition 4 . However, the efficacy of these drugs is commonly encumbered by diarrhoea, which occurs in nearly 50% of patients 5 – 7 and often requires dose reduction and temporary drug interruption 8 .…”

Section: Introductionmentioning

confidence: 99%

Faecal microbiota transplantation for the treatment of diarrhoea induced by tyrosine-kinase inhibitors in patients with metastatic renal cell carcinoma

et al. 2020

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Diarrhoea is one of the most burdensome and common adverse events of chemotherapeutics, and has no standardised therapy to date. Increasing evidence suggests that the gut microbiome can influence the development of chemotherapy-induced diarrhoea. Here we report findings from a randomised clinical trial of faecal microbiota transplantation (FMT) to treat diarrhoea induced by tyrosine kinase inhibitors (TKI) in patients with metastatic renal cell carcinoma (ClinicalTrials.gov number: NCT04040712). The primary outcome is the resolution of diarrhoea four weeks after the end of treatments. Twenty patients are randomised to receive FMT from healthy donors or placebo FMT (vehicle only). Donor FMT is more effective than placebo FMT in treating TKI-induced diarrhoea, and a successful engraftment is observed in subjects receiving donor faeces. No serious adverse events are observed in both treatment arms. The trial meets pre-specified endpoints. Our findings suggest that the therapeutic manipulation of gut microbiota may become a promising treatment option to manage TKI-dependent diarrhoea.

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Survival outcomes for advanced kidney cancer patients in the era of targeted therapies

Cited by 43 publications

References 13 publications

Real-World Evidence Data on Metastatic Renal-Cell Carcinoma Treatment in Austria: The RELACS Study

Real-World Evidence Data on Metastatic Renal-Cell Carcinoma Treatment in Austria: The RELACS Study

Life expectancy in patients with metastatic renal cell carcinoma in the Russian Federation: results of the RENSUR3 multicenter registry study

Faecal microbiota transplantation for the treatment of diarrhoea induced by tyrosine-kinase inhibitors in patients with metastatic renal cell carcinoma

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