Outcomes of systemic targeted therapy in recurrent renal cell carcinoma treated with adjuvant sunitinib.
Guillermo de Velasco, Álvaro Ruiz-Granados, Oscar Reig, Francesco Massari, Miguel Angel Climent Duran, Elena Verzoni, Jeffrey Graham, Roberto Llarena, Michele De Tursi, Frede Donskov, Clara Iglesias, Hardev S Pandha, Xavier Garcia Del Muro, Giuseppe Procopio, Stephane Oudard, Daniel Castellano, Laurence Albiges
Author Information
Guillermo de Velasco: Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
Álvaro Ruiz-Granados: Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
Oscar Reig: Translational Genomics and Targeted Therapeutics in Solid Tumours Lab, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Francesco Massari: Oncologia Medica, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia.
Miguel Angel Climent Duran: Instituto Valenciano de Oncología, Valencia, Spain.
Elena Verzoni: Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
Jeffrey Graham: University of Manitoba, Winnipeg, MB, Canada.
Roberto Llarena: Hospital Universitario de Cruces, Barakaldo, Spain.
Michele De Tursi: Department of Oncology and Neurosciences, Consorzio Interuniversitario Nazionale per la Bio-Oncologia, University G. d'Annunzio, Chieti, Italy.
Frede Donskov: Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Clara Iglesias: Hospital Universitario Central de Asturias, Oviedo, Spain.
Hardev S Pandha: University of Surrey, Surrey, UK.
Xavier Garcia Del Muro: Department of Medical Oncology, Institut Català d'Oncologia L'Hospitalet, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain.
Giuseppe Procopio: Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Stephane Oudard: Medical Oncology Department, Georges Pompidou Hospital, University of Paris, Paris, France. ORCID
Daniel Castellano: Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
Laurence Albiges: Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
OBJECTIVE: To assess the efficacy and tolerability of rechallenge with sunitinib and other targeted therapies (TTs) in patitents with relapsed recurrent renal cell carcinoma (RCC) in the advanced setting. METHODS: In this multi-institutional retrospective study, patients with relapsed RCC were rechallenged with sunitinib or other systemic TTs as a first-line therapeutic approach after failed adjuvant sunitinib treatment. Patient characteristics, treatments and clinical outcomes were recorded. The primary endpoint was progression-free survival (PFS). Secondary endpoints were objective response rate (ORR) and overall survival (OS). RESULTS: A total of 34 patients with relapses were recorded, and 25 of these (73.5%) were men. Twenty-five patients were treated with systemic TT: 65% of patients received TT against the vascular endothelial growth factor pathway (including sunitinib), 21.7% received mammalian target of rapamycin inhibitors and 13% received immunotherapy. The median (interquartile range) time to relapse was 20.3 (5.2-20.4) months from diagnosis, and 7.5 months (1.0-8.5) from the end of adjuvant suntinib treatment. At a median follow-up of 23.5 months, 24 of the 25 patients had progressed on first-line systemic therapy. The median PFS was 12.0 months (95% confidence interval [CI] 5.78-18.2). There were no statistical differences in PFS between different treatments or sunitinib rechallenge. PFS was not statistically different in patients relapsing on or after adjuvant suntinib treatment (≤ 6 or >6 months after adjuvant suntinib ending). The ORR was 20.5%. The median OS was 29.1 months (95% CI 16.4-41.8). CONCLUSIONS: Rechallenge with sunitinib or other systemic therapies is still a feasible therapeutic option that provides patients with advanced or metastastic RCC with additional clinical benefits with regard to PFS and OS after failed response to adjuvant sunitinib.
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