Document Detail


The association of clinical outcome to first-line VEGF-targeted therapy with clinical outcome to second-line VEGF-targeted therapy in metastatic renal cell carcinoma patients.
MedLine Citation:
PMID:  23300029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There are many active drugs to treat metastatic renal cell carcinoma (mRCC) patients who progress through their first-line vascular endothelial growth factor (VEGF) inhibitor. Many clinicians choose a second-line VEGF inhibitor based on the type of response to first-line VEGF inhibitor, without data supporting this practice. This study was conducted to determine the association of response to second-line VEGF inhibitor with response to first-line VEGF inhibitor. All mRCC patients in participating centers of the International mRCC Database Consortium who were treated from January 2004 through June 2011 with a second-line VEGF inhibitor after failure of a different first-line VEGF inhibitor were retrospectively identified. The primary outcome is objective response rate (ORR) and the secondary outcome is progression-free survival (PFS) in each line of therapy. Of 1,602 total database patients, 464 patients received a first- and second-line VEGF inhibitor. The ORR to first-line therapy was 22%, and the ORR to second-line therapy was 11%. The ORR to second-line therapy was not different among patients achieving partial response versus stable disease versus progressive disease to first-line therapy (14% vs. 10% vs. 11%, respectively; chi-squared trend test p=0.17). The median PFS on first-line VEGF-targeted therapy was 7.5 months (95% CI, 6.6-8.1), and the median PFS on second-line VEGF inhibitor was 3.9 months (95% CI, 3.6-4.5). There was no correlation between first-line and second-line PFS (Pearson correlation coefficient 0.025; p=0.59). The clinical response to a second-line VEGF inhibitor is not dependent on response to the first-line VEGF-inhibitor. Further studies are needed to define clinical parameters that predict response to second-line therapy to optimize the sequence of VEGF-targeted therapy in metastatic RCC patients.
Authors:
Mhd Y Al-Marrawi; Brian I Rini; Lauren C Harshman; Georg Bjarnason; Lori Wood; Ulka Vaishampayan; Mary MacKenzie; Jennifer J Knox; Neeraj Agarwal; Hulayel Al-Harbi; Christian Kollmannsberger; Min-Han Tan; Sun Young Rha; Frede N Donskov; Scott North; Toni K Choueiri; Daniel Y Heng;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-09
Journal Detail:
Title:  Targeted oncology     Volume:  8     ISSN:  1776-260X     ISO Abbreviation:  Target Oncol     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-09-05     Completed Date:  2014-06-06     Revised Date:  2014-07-22    
Medline Journal Info:
Nlm Unique ID:  101270595     Medline TA:  Target Oncol     Country:  France    
Other Details:
Languages:  eng     Pagination:  203-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Agents / pharmacology,  therapeutic use*
Carcinoma, Renal Cell / drug therapy*,  pathology
Disease-Free Survival
Female
Humans
Kidney Neoplasms / drug therapy*,  pathology
Male
Middle Aged
Molecular Targeted Therapy
Neoplasm Metastasis
Retrospective Studies
TOR Serine-Threonine Kinases / antagonists & inhibitors
Treatment Outcome
Vascular Endothelial Growth Factor A / antagonists & inhibitors*
Grant Support
ID/Acronym/Agency:
P30 CA022453/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/VEGFA protein, human; 0/Vascular Endothelial Growth Factor A; EC 2.7.1.1/MTOR protein, human; EC 2.7.1.1/TOR Serine-Threonine Kinases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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