Association between time from diagnosis to initiation of systemic therapy of metastatic renal cell carcinoma with treatment outcome

  • Nikola Lisičić Medicinski fakultet Univerziteta u Beogradu, doktor medicine
  • Angelina Kević Medicinski fakultet u Beogradu
  • Marko Savić Institut za medicinsku statistiku i informatiku, Medicinski fakultet u Beogradu
  • Predrag Nikić Medicinski fakultet u Beogradu ; Klinika za Urologiju UKCS
Ključne reči: Keywords: mRCC, systemic therapy, treatment response, observational study, sunitinib

Sažetak


Introduction: In about 30% of cases, renal cell carcinoma (RCC) is detected initialy in the metastatic stage (mRCC). The mainstay of mRCC treatment is anti-angiogenesis targeted therapy and immunotherapy that both have significantly prolonged progression-free survival and overall survival in patients with mRCC.

Aim: The aim of this study was to examine the association between time interval from diagnosis of mRCC to the start of systemic therapy with the radiologically assessed best treatment response after 12 months of therapy.

Material and methods: This observational study included 85 patients diagnosed initially in the metastatic stage of RCC. All patients received single agent systemic targeted therapy sunitinib. The minimum follow-up period was 12 months. Radiologic assessment was performed after every 3 months, and the RECIST criteria were used to evaluate the best treatment response.

Ressults: The mean time interval from mRCC diagnosis to the start of systemic targeted therapy was 3.5 ± 2.5 months, with a median of 2 months. No statistically significant association was observed between the best radiologically assessed treatment response after 12 months of therapy and time interval  from diagnosis of mRCC to the start of systemic targeted therapy (p = 0.7). Moreover, no statistically significant association was found between the best radiologically assessed treatment response after 12 months of therapy and total number of metastatic sites at baseline.

Conclusion:  No association was observed between the best radiologically assessed treatment response after 12 months of systemic targeted therapy, neither with time interval from mRCC diagnosis to the start of systemic targeted therapy, nor with the total number of metastatic sites in patients who were initially diagnosed with mRCC and received sunitinib in first line setting.

Biografije autora

Angelina Kević, Medicinski fakultet u Beogradu

Doktor medicine

Marko Savić, Institut za medicinsku statistiku i informatiku, Medicinski fakultet u Beogradu

Master menadžer u oblasti javnog zdravlja

Predrag Nikić, Medicinski fakultet u Beogradu ; Klinika za Urologiju UKCS

Docent

Reference

1. Padala SA, Barsouk A, Thandra KC, Saginala K, Mohammed A, Vakiti A, et al. Epidemiology of Renal Cell Carcinoma. World J Oncol. 2020;11(3):79-87.
2. Capitanio U, Bensalah K, Bex A, Boorjian SA, Bray F, Coleman J, et al. Epidemiology of Renal Cell Carcinoma. Eur Urol. 2019;75(1):74-84.
3. Cairns P. Renal cell carcinoma. Cancer Biomark. 2010;9(1-6):461-473.
4. Gray RE, Harris GT. Renal Cell Carcinoma: Diagnosis and Management [published correction appears in Am Fam Physician. 2019 Jun 15;99(12):732]. Am Fam Physician. 2019;99(3):179-184.
5. EAU Guidelines: Renal Cell Carcinoma | Uroweb Available from: https://uroweb.org/guideline/renal-cell-carcinoma/ [Accessed 3rd January 2021].
6. Escudier B, Porta C, Schmidinger M, Rioux-Leclercq N, Bex A, Khoo V, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2019;30(5):706-720.
7. Sato T, Kawasaki Y, Maekawa M, Takasaki S, Saigusa D, Ota H, et al. Value of global metabolomics in association with diagnosis and clinicopathological factors of renal cell carcinoma. Int J Cancer. 2019;145(2):484-493.
8. Yuan ZX, Mo J, Zhao G, Shu G, Fu HL, Zhao W. Targeting Strategies for Renal Cell Carcinoma: From Renal Cancer Cells to Renal Cancer Stem Cells. Front Pharmacol. 2016;7:423.
9. Molina AM, Motzer RJ. Clinical practice guidelines for the treatment of metastatic renal cell carcinoma: today and tomorrow. Oncologist. 2011;16:45-50.
10. Lista C. Lekovi sa posebnim režimom izdavanja. Available from: https://www.rfzo.rs/download/pravilnici/lekovi/C Lista_primena od 04.04.2020..pdf [Accessed 4th January 2021].
11. Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, et al. Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol. 2009;27(34):5794-5799.
12. Fisher R, Pender A, Thillai K, Chowdhury S, Pickering L, Khabra K, et al. Observation as a treatment strategy for advanced renal cell carcinoma-a call for prospective validation. Front Oncol. 2012;2:155.
13. Rini BI, Dorff TB, Elson P, Rodriguez CS, Shepard D, Wood L, et al. Active surveillance in metastatic renal-cell carcinoma: a prospective, phase 2 trial. Lancet Oncol. 2016;17(9):1317-1324.
14. Heng DY, Xie W, Regan MM, Harshman LC, Bjarnason GA, Vaishampayan UN, et al. External validation and comparison with other models of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model: a population-based study. Lancet Oncol. 2013;14(2):141-148.
15. Neeman E, Gresham G, Ovasapians N, Hendifar A, Tuli R, Figlin R, et al. Comparing Physician and Nurse Eastern Cooperative Oncology Group Performance Status (ECOG-PS) Ratings as Predictors of Clinical Outcomes in Patients with Cancer. Oncologist. 2019;24(12):e1460-e1466.
16. Morgan RL, Camidge DR. Reviewing RECIST in the Era of Prolonged and Targeted Therapy. J Thorac Oncol. 2018;13(2):154-164.
17. Maroun R, Mitrofan L, Benjamin L, Nachbaur G, Maunoury F, Le Jeunne P, et al. Real life patterns of care and progression free survival in metastatic renal cell carcinoma patients: retrospective analysis of cross-sectional data. BMC Cancer. 2018;18(1):214.
18. Badran A, Elshenawy MA, Shahin A, Aljubran A, Alzahrani A, Eldali A, et al. Efficacy and Prognostic Factors of Sunitinib as First-Line Therapy for Patients With Metastatic Renal Cell Carcinoma in an Arab Population. JCO Glob Oncol. 2020;6:19-26.
19. van der Veldt AA, Boven E, Helgason HH, van Wouwe M, Berkhof J, de Gast G, et al. Predictive factors for severe toxicity of sunitinib in unselected patients with advanced renal cell cancer. Br J Cancer. 2008;99(2):259-265.
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2023/11/29
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