Safety and efficacy of targeted therapy for renal cell carcinoma (RCC) with brain metastasis

Autor: Diogo Assed Bastos, Ana M. Molina, Xiaoyu Jia, Susanne Velasco, Sujata Patil, Martin Henner Voss, Darren Richard Feldman, Robert John Motzer
Rok vydání: 2014
Předmět:
Zdroj: Journal of Clinical Oncology. 32:497-497
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2014.32.4_suppl.497
Popis: 497 Background: Brain metastases (Bm) in RCC are associated with poor prognosis. The safety and efficacy of TT in this setting is not well established since patients (pts) with Bm were excluded from pivotal clinical trials. The primary objective was to assess safety and efficacy of TT in pts with Bm. Methods: Pts with mRCC treated with ≥ 28 days of TT after Bm diagnoses were retrospectively identified. Kaplan-Meier method and Cox proportional hazards model were used to analyze the association between clinical features and OS. Results: 65 pts were identified, including 52 (80%) treated with anti-angiogenic agents and 13 (20%) treated with mTOR inhibitors. Most pts had extracranial metastasis (98%) and 54% had ≥ 2 brain lesions. Fifty seven pts (88%) had local therapy for Bm before TT including surgery in 3 (5%), radiation therapy (RT) in 36 (55%) and both surgery and RT in 18 (28%). Median follow-up was 12.3 months (1.1 – 58.8). Median treatment duration was 3.4 months (0.3 – 31.9) for 1st line and 1.9 months (0.2 – 23.6) for 2nd line. Median OS was 12.2 months (95% CI 8.0 to 15.5). On univariate analysis using various clinical and treatment variables, MSKCC risk group (p = 0.001), histology subtype (clear vs other) (p < 0.0001), and number of Bm at diagnosis (p = 0.004) correlated with OS and retained statistical significance on multivariate analysis (Table). CNS complications were identified in only 5 pts (8%), including 2 with radiation necrosis and 3 with Bm hemorrhage. Conclusions: The use of targeted agents for pts with RCC and Bm appears safe with OS that compares favorably to historical results in the pre-TT era. Clear cell RCC, favorable MSKCC risk status, and solitary Bm are associated with better outcome. [Table: see text]
Databáze: OpenAIRE
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