Cancer Res Treat.  2019 Oct;51(4):1578-1588. 10.4143/crt.2018.671.

Temsirolimus in Asian Metastatic/Recurrent Non-clear Cell Renal Carcinoma

• Lee JB
• Park HS
• Park S
• Lee HJ
• Kwon KA
• Choi YJ
• Kim YJ
• Nam CM
• Cho NH
• Kang B
• Chung HC
• Rha SY

• KMID: 2460606
• DOI: http://doi.org/10.4143/crt.2018.671

Abstract

PURPOSE
Temsirolimus is effective in the treatment for metastatic non-clear cell renal cell carcinoma (nccRCC) with poor prognosis. We aim to investigate the efficacy and tolerability of temsirolimus in treatment of naïve Asian patients with metastatic/recurrent nccRCC.
MATERIALS AND METHODS
From January 2008 to July 2017, data of treatment-naïve, metastatic/recurrent nccRCC patients, who were treated with temsirolimus according to the standard protocol, were collected. The primary end-point was progression-free survival (PFS). Secondary end points were overall survival (OS), objective response rate (ORR), and tolerability of temsirolimus.
RESULTS
Forty-four metastatic/recurrent nccRCC patients, 10 from prospective and 34 from retrospective groups, were enrolled; 24 patients (54%) were papillary type, and other histology subtypes included 11 chromophobes (25%), two collecting ducts (5%), one Xp11.2 translocation (2%), and six others (14%). The median PFS and OS were 7.6 months and 17.6 months, res-pectively. ORR was 11% and disease control rate was 83%. Patients with prior nephrectomy had longer PFS (hazard ratio [HR], 0.16; 95% confidence interval [CI], 0.06 to 0.42; p < 0.001) and OS (HR, 0.15; 95% CI, 0.05 to 0.45; p < 0.001). Compared to favorable/intermediate prognosis group, poor prognosis group had shorter median PFS (4.7 months vs. 7.6 months [HR, 2.91; 95% CI, 1.39 to 6.12; p=0.005]) and median OS (9.2 months vs. 17.6 months [HR, 2.84; 95% CI, 1.23 to 6.56; p=0.015]).
CONCLUSION
Temsirolimus not only benefits poor-risk nccRCC patients, but it is also effective in favorable or intermediate-risk group in Asians. Temsirolimus was well-tolerated with manageable adverse events.

Keyword

Temsirolimus; First-line; Asian; Renal cell carcinoma; Efficacy; Tolerability

MeSH Terms

Asian Continental Ancestry Group*
Carcinoma, Renal Cell
Disease-Free Survival
Humans
Nephrectomy
Prognosis
Prospective Studies
Retrospective Studies

Figure

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  Fig. 1. Efficacy of temsirolimus in non-clear cell renal cell carcinoma. (A) Progression-free survival (PFS). (B) Overall survival (OS). CI, confidence interval.

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  Fig. 2. Kaplan-Meier curves of progression-free survival (PFS) according to subgroups. (A) With or without sarcomatoid features. (B) Papillary, chromophobe, others. (C) Prognostic group by Advanced Renal Cell Cancer criteria. HR, hazard ratio; CI, confidence interval.

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  Fig. 3. Kaplan-Meier curves of overall survival (OS) according to subgroups. (A) With or without sarcomatoid features. (B) Papillary, chromophobe, others. (C) Prognostic group by Advanced Renal Cell Cancer criteria. HR, hazard ratio; CI, confidence interval.

Reference

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