Cancer Res Treat.  2016 Jul;48(3):1092-1101. 10.4143/crt.2015.316.

Systemic Treatments for Metastatic Renal Cell Carcinoma: 10-Year Experience of Immunotherapy and Targeted Therapy

• Kim SH
• Park WS
• Kim SH
• Joung JY
• Seo HK
• Lee KH
• Chung J

• KMID: 2344083
• DOI: http://doi.org/10.4143/crt.2015.316

Abstract

PURPOSE
The purpose of this study is to compare the outcomes of first-line systemic targeted therapy (TT) and immunotherapy (IT) in patients with metastatic renal cell carcinoma (mRCC).
MATERIALS AND METHODS
This study was a retrospective review of the data of 262 patients treated with systemic IT or TT with tyrosine kinase inhibitors between 2003 and 2013. The objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were assessed using Response Evaluation Criteria in Solid Tumor ver. 1.0 criteria and the Kaplan-Meier method with log-rank test.
RESULTS
During the median 4.3-month treatment and the 24-month follow-up period, the ORR/PFS/OS of the overall first-line and second-line therapy were 41.9%/8.1 months/16.8 months and 27.5%/6.5 months/15.3 months, respectively. The first-line TT/IT/sequential IT had a PFS of 9.3/6.4/5.7 months and an OS of 15.8/16.5/40.6 months (all p < 0.05). The second-line of TT/IT had a PFS of 7.1/2.1 months (both p < 0.05) and an OS of 16.6/8.6 months (p=0.636), respectively. Pazopanib provided the best median PFS of 11.0 months (p < 0.001) and a quadruple IT regimen had a superior PFS (p=0.522). For OS, sequential treatment with IT and TT was superior compared to treatment with either IT or TT alone (40.6/16.5/15.8 months, p=0.014). The prognosis according to the Memorial Sloan Kettering Cancer Center model showed that favorable/intermediate/poor risk groups had a PFS of 8.5/10.4/2.3 months, and an OS of 43.1/20.4/5.6 months, respectively. The prognosis calculated using the Heng model showed that the favorable/intermediate/poor risk groups had a PFS of 9.2/3.9/2.7 months, and an OS of 32.4/16.5/6.1months, respectively (all p < 0.001).
CONCLUSION
In patients with mRCC, TT provided a better PFS and OS compared with IT.

Keyword

Immunotherapy; Molecular targeted therapy; Prognosis; Renal cell carcinoma; Neoplasm metastasis

MeSH Terms

Carcinoma, Renal Cell*
Disease-Free Survival
Follow-Up Studies
Humans
Immunotherapy*
Methods
Molecular Targeted Therapy
Neoplasm Metastasis
Prognosis
Protein-Tyrosine Kinases
Retrospective Studies
Protein-Tyrosine Kinases

Figure

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  Fig. 1. Progression-free survival (PFS) (A) and overall survival (OS) (B) curves for first-line systemic therapies in patients with metastatic renal cell carcinoma treated with immunotherapy alone, targeted therapy alone, or both therapies in sequence. ICTx, immunotherapy; TT, targeted therapy.

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  Fig. 2. Progression-free survival curves for first-line systemic therapies in patients with metastatic renal cell carcinoma. ICTx, immunotherapy.

Reference

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