Treatment selection for first‐line metastatic renal cell carcinoma in Australia: Impact of new therapy options

Schmidt, Andrew; Azad, Arun; Goh, Jeffrey C.; Harris, Carole A.; Joshua, Anthony M.; Weickhardt, Andrew; Krieger, Laurence E.

doi:10.1111/ajco.13289

Cited by 5 publications

(5 citation statements)

References 47 publications

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“…Despite clinically improved outcomes in advanced RCC, it is believed that resistance to VEGF-targeted treatment develops in nearly all patients with RCC [ 5 ]. In our study, the occurrence of cross-resistance was not observed in all cases during follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with advanced RCC develop new metastatic lesions up to 10–30% despite being treated with new drugs, including vascular endothelial growth factor-tyrosine kinase inhibitor (VEGF-TKI) or targeted therapies [ 3 , 4 ]. Additionally, between 20 to 30% of patients with localized RCC experience relapse in distant sites within 3 years of surgical resection [ 5 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Sorafenib as a second-line treatment in metastatic renal cell carcinoma in Mexico: a prospective cohort study

2021

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Background Sequential inhibition of the vascular endothelial growth factor (VEGF) pathway with sorafenib could be useful for patients with metastatic renal cell carcinoma (RCC). Our aim was to determine the activity and tolerability of sorafenib as a second-line therapy in advanced RCC initially treated with a different VEGF-tyrosine kinase inhibitor (TKI). Methods A prospective observational cohort in Mexico (2012–2019). We included 132 subjects with metastatic RCC and who had progression despite treatment with sunitinib. The primary end-point was time to disease progression as evaluated every 12–16 weeks. Results The mean age of the cohort was 59 years (interquartile range [IQR] 50–72), 96 (73%) were men, and 48 (36%) had a favorable prognosis according to the IMDC (International Metastatic RCC Database Consortium) prognostic model. The median progression-free survival (PFS) and overall-survival after the introduction of sorafenib treatment was 8.6 months (95% confidence interval [CI]: 6.7–10.5) and 40 months (95% CI: 34.5–45.4) respectively. The median overall survival from RCC diagnosis to death was 71 months (95% CI: 58.2–83.8). On multivariable analyses, age > 65 years was associated with a longer PFS (HR 0.51; 95% CI: 0.31–0.86; p = 0.018). The median PFS in subjects aged > 65 years was longer compared to subjects ≤65 years (14.0 [95% CI: 9.2–18.8] vs. 7.2 months [95% CI: 5.3–9.1]; p = 0.012). Adverse events grade ≥ 3 associated with sorafenib occurred in 38 (29%) patients. Conclusion Sequential inhibition of VEGF with sorafenib as a second-line treatment may benefit patients with metastatic RCC, especially in subjects > 65 years old.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sorafenib as a second-line treatment in metastatic renal cell carcinoma in Mexico: a prospective cohort study

2021

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“…In recent decades, considerable advances in tumor therapy have significantly improved the overall survival of mRCC patients [14,15]. BM in RCC is still an important topic in the field of kidney malignancy research.…”

Section: Discussionmentioning

confidence: 99%

Construction and Validation of a Convenient Clinical Nomogram to Predict the Risk of Brain Metastasis in Renal Cell Carcinoma Patients

Tong

Huang

et al. 2020

BioMed Research International

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Brain metastasis (BM) is a typical type of metastasis in renal cell carcinoma (RCC) patients. The early detection of BM is likely a crucial step for RCC patients to receive appropriate treatment and prolong their overall survival. The aim of this study was to identify the independent predictors of BM and construct a nomogram to predict the risk of BM. Demographic and clinicopathological data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database for RCC patients between 2010 and 2015. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors, and then, a visual nomogram was constructed. Multiple parameters were used to evaluate the discrimination and clinical value. We finally included 42577 RCC patients. Multivariate logistic regression analysis showed that histological type, tumor size, bone metastatic status, and lung metastatic status were independent BM-associated risk factors for RCC. We developed a nomogram to predict the risk of BM in patients with RCC, which showed favorable calibration with a C -index of 0.924 (0.903-0.945) in the training cohort and 0.911 (0.871-0.952) in the validation cohort. The calibration curves and decision curve analysis (DCA) also demonstrated the reliability and accuracy of the clinical prediction model. The nomogram was shown to be a practical, precise, and personalized clinical tool for identifying the RCC patients with a high risk of BM, which not only will contribute to the more reasonable allocation of medical resources but will also enable a further improvements in the prognosis and quality of life of RCC patients.

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“…Patients with advanced RCC develop new metastatic lesions up to 10-30% despite being treated with new drugs, including vascular endothelial growth factor-tyrosine kinase inhibitor (VEGF-TKI) or targeted therapies (3,4). Additionally, between 20-30% of patients with localized RCC experience relapse in distant sites within 3 years of surgical resection (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Sorafenib as a Second-Line Treatment in Metastatic Renal Cell Carcinoma in Mexico: A Prospective Cohort Study

Martin-Aguilar

Núñez-López

Ramirez‐Sandoval

2020

Preprint

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Background: Sequential inhibition of the vascular endothelial growth factor (VEGF) pathway with sorafenib could be useful for patients with metastatic renal cell carcinoma (RCC). Our aim was to determine the activity and tolerability of sorafenib as a second-line therapy in advanced RCC initially treated with a different VEGF-tyrosine kinase inhibitor (TKI).Methods: A prospective observational cohort in Mexico (2012–2019). We included 148 subjects with metastatic RCC and who had progression despite treatment with sunitinib (n = 144) or pazopanib (n = 4). The primary end-point was time to disease progression as evaluated every 12–16 weeks.Results: The mean age of the cohort was 58 years (interquartile range [IQR] 48-68), 104 (70%) were men, and 51 (35%) had a favorable prognosis according to the IMDC (International Metastatic RCC Database Consortium) prognostic model. The median progression-free survival (PFS) and overall-survival after the introduction of sorafenib treatment was 8.5 months (95% confidence interval [CI]: 6.8–10.2) and 40.1 months (95% CI: 35.2–45.0) respectively. The median overall survival from RCC diagnosis to death was 71 months (95% CI: 63.9–79.4). On multivariate analyses, age >65 years was associated with a longer PFS (HR 0.57; 95% CI: 0.35-0.93; p = 0.025). The median PFS in subjects aged >65 years was longer compared to subjects ≤65 years (14.0 [95% CI: 9.2–17.9] vs. 7.2 months [95% CI: 5.5–8.9]; p = 0.018). Adverse events grade ≥3 associated with sorafenib occurred in 42 (28%) patients.Conclusion: Sequential inhibition of VEGF with sorafenib as a second-line treatment may benefit patients with metastatic RCC, especially in subjects >65 years old.

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Treatment selection for first‐line metastatic renal cell carcinoma in Australia: Impact of new therapy options

Cited by 5 publications

References 47 publications

Sorafenib as a second-line treatment in metastatic renal cell carcinoma in Mexico: a prospective cohort study

Sorafenib as a second-line treatment in metastatic renal cell carcinoma in Mexico: a prospective cohort study

Construction and Validation of a Convenient Clinical Nomogram to Predict the Risk of Brain Metastasis in Renal Cell Carcinoma Patients

Sorafenib as a Second-Line Treatment in Metastatic Renal Cell Carcinoma in Mexico: A Prospective Cohort Study

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