Predictors of response to sequential sunitinib and the impact of prior VEGF-targeted drug washout in patients with metastatic clear-cell renal cell carcinoma
| Autor: | William Oh, Michael B. Atkins, Sujata S. Jayawant, David F. McDermott, Mei Sheng Duh, Jonathan E. Rosenberg, Barry Fortner, L. Antras, Toni K. Choueiri, Daniel C. Cho, Aymen Elfiky, Kristina Chen |
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| Rok vydání: | 2009 |
| Předmět: |
Sorafenib
Oncology Male Vascular Endothelial Growth Factor A medicine.medical_specialty Indoles Bevacizumab Anemia Urology Antineoplastic Agents Kaplan-Meier Estimate urologic and male genital diseases Disease-Free Survival Internal medicine medicine Carcinoma Sunitinib Humans Pyrroles Carcinoma Renal Cell Aged Retrospective Studies business.industry Retrospective cohort study Middle Aged medicine.disease female genital diseases and pregnancy complications Kidney Neoplasms Clear cell renal cell carcinoma Drug Resistance Neoplasm Female business medicine.drug Brain metastasis |
| Zdroj: | Urologic oncology. 29(6) |
| ISSN: | 1873-2496 |
| Popis: | To identify factors that can be used to identify metastatic clear cell RCC patients more likely to benefit from sequential sunitinib.We identified patients who failed sorafenib or bevacizumab and subsequently received sunitinib. We looked at objective response rates (ORR), progression-free survival (PFS), and overall survival (OS) to sunitinib in relation to baseline clinical variables.Seventy-one patients received sunitinib sequential therapy. Median duration of follow-up after starting sunitinib was 9.3 months. Median PFS was 5.8 months; median OS was not reached. Significantly higher ORR was seen in patients with normal hemoglobin (25.6%) [defined as12 gm/dl for female;13 gm/dl for male]. In addition, a shorter PFS for patients with low hemoglobin, and patients with time from diagnosis to first treatment ≤ 1 year was found. There was a shorter OS for patients ≥ 60 years old, with brain metastasis, low hemoglobin, and time from diagnosis to treatment ≤ 1 year. There was no difference in ORR, PFS, or OS in patients who started sunitinib after or within a 30-day period.Metastatic clear-cell RCC patients with anemia have less clinical benefit from sequential sunitinib after failure of bevacizumab or sorafenib. Other factors associated with poor outcome include brain metastases, older age, and1 year between diagnosis and first treatment. Importantly, no difference in outcomes was observed if sequential therapy was initiated within or after 30 days. External validation and prospective evaluation are needed to confirm these findings. |
| Databáze: | OpenAIRE |
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