Second-line treatment outcomes after first-line sunitinib therapy in metastatic renal cell carcinoma.

Abstract

This study was conducted to evaluate the treatment outcomes associated with common second-line targeted therapies given after first-line sunitinib for metastatic renal cell carcinoma (mRCC). The sample comprised patients with mRCC (n = 257) who were receiving second-line everolimus, sorafenib, or temsirolimus between April 1, 2008, and February 29, 2011, after first-line sunitinib treatment. The patients were followed-up from the start of second-line treatment until treatment failure (defined as advancement to a third-line therapy or to mortality) or the last observation in the medical and pharmacy databases. Treatment failure was observed in 38.5% (n = 99) of cases: 20.2% of patients (n = 52) advanced a line of treatment; and 18.3% of patients (n = 47) died. Kaplan-Meier analysis indicated a statistical difference in time to treatment failure among the 3 second-line targeted therapies (log-rank test, P = .045). The estimated 1-year cumulative probabilities of treatment failure were 49.9% for everolimus, 68.4% for sorafenib, and 71.4% for temsirolimus. In a multivariate Cox proportional hazards model, a higher adjusted risk of treatment failure vs. everolimus was observed for both temsirolimus (hazard ratio [HR] 2.05 [95% CI, 1.26-3.35]; P = .004) and sorafenib (HR 1.77 [95% CI, 1.02-3.07]; P = .043). The results of this real-world data analysis suggest that the risk of second-line treatment failure after first-line sunitinib was significantly higher with temsirolimus and sorafenib compared with everolimus.

• Authors: Chi-Chang Chen, Gregory P Hess, Zhimei Liu, Dean H Gesme, Sanjiv S Agarwala, Carlos C Garay, Jerrold W Hill, Amy Guo
• Journal: Clinical genitourinary cancer (Clin Genitourin Cancer) Vol. 10 Issue 4 Pg. 256-61 (Dec 2012) ISSN: 1938-0682 [Electronic] United States
• PMID: 22682982 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Antineoplastic Agents
• Indoles
• Phenylurea Compounds
• Pyrroles
• Niacinamide
• temsirolimus
• Everolimus
• Sorafenib
• Sunitinib
• Sirolimus

Topics

• Aged
• Antineoplastic Agents (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Renal Cell (drug therapy, secondary)
• Everolimus
• Female
• Humans
• Indoles (therapeutic use)
• Kaplan-Meier Estimate
• Kidney Neoplasms (drug therapy, pathology)
• Male
• Middle Aged
• Niacinamide (administration & dosage, analogs & derivatives)
• Phenylurea Compounds (administration & dosage)
• Pyrroles (therapeutic use)
• Retrospective Studies
• Sirolimus (administration & dosage, analogs & derivatives)
• Sorafenib
• Sunitinib
• Treatment Outcome