Everolimus is indicated for the
therapy of adults with advanced
renal cell carcinoma after failure of treatment with
vascular endothelial growth factor receptor (VEGFR)
tyrosine kinase inhibitor (TKI). The aim of the study was a multicenter evaluation of efficiency and toxicity of
everolimus in patients with metastatic
renal carcinoma who received one line of VEGFR-TKI
therapy. Data of one hundred and one patients were analyzed retrospectively. Patients received
everolimus therapy between January 2010 and July 2013. Data were collected in 7 different oncology institutes in Hungary. Starting daily dose of
everolimus was 10 mg in 28-day cycles. Physical and laboratory examinations were done monthly. Imaging tests were performed every 3 months.
Tumor response and toxicity were evaluated according to RECIST 1.0 and NCI CTCAE 3.0, respectively. Statistical analysis was performed with
SPPS version 20.0 for Windows. Currently 26 (27%) patients are being treated, 52 (54.1%) patients are alive. Median progression-free survival (PFS) was 5.7 months (95% CI 4.07-7.33). Partial remission, stable disease and progression occurred in 6 (6%), 71 (74%) and 19 (20%) patients, respectively. Median overall survival (OS) was 14.3 months (95% CI 6.99-19.81). PFS and OS results were more favorable in patients with ECOG 0-1. Survival was poorer in case of
anemia, while better if PFS was longer than 12 months. In anemic patients with ECOG 0-1 and ECOG 2-3 OS was 30.9 and 7.7 months, respectively (p=0.031).
Dose reduction and
treatment delay happened in 8 (7.9%) and 12 (11.9%) cases, respectively. The most common side effects were the following:
exanthema,
edema,
stomatitis,
pneumonitis,
anemia and abnormal kidney-, liver functions,
blood sugar and
cholesterol levels. According to the Hungarian experience,
everolimus can safely be administered. PFS and OS results representing the centers' everyday practice, are similar to the results of the respective subgroups in the registration study.