Nimira Alimohamed1, Jae-Lyn Lee2, Sandy Srinivas3, Georg A Bjarnason4, Jennifer J Knox5, Mary J Mackenzie6, Lori Wood7, Ulka N Vaishampayan8, Min-Han Tan9, Sun Young Rha10, Frede Donskov11, Srinivas Tantravahi12, Christian Kollmannsberger13, Scott North14, Brian I Rini15, Toni K Choueiri16, Daniel Y C Heng17. 1. Princess Margaret Hospital, Toronto, Ontario, Canada. Electronic address: nimira.alimohamed@uhn.ca. 2. Asan Medical Centre, Seoul, South Korea. 3. Stanford Cancer Centre, Stanford, CA. 4. Sunnybrook Odette Cancer Institute, Toronto, Ontario, Canada. 5. Princess Margaret Hospital, Toronto, Ontario, Canada. 6. London Health Sciences Center, London, Ontario, Canada. 7. Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada. 8. Wayne State University, Detroit, MI. 9. National Cancer Center, Institute of Bioengineering and Nanotechnology, Singapore. 10. Yonsei University Hospital, Seoul, South Korea. 11. Aarhus University Hospital, Aarhus, Denmark. 12. Huntsman Cancer Institute, Salt Lake City, UT. 13. BC Cancer Agency, Vancouver, British Columbia, Canada. 14. Cross Cancer Institute, Edmonton, Alberta, Canada. 15. Cleveland Clinic Taussig Cancer Institute, Cleveland, OH. 16. Dana-Farber Cancer Institute, Harvard University, Boston, MA. 17. Tom Baker Cancer Centre, Calgary, Alberta, Canada.
Abstract
BACKGROUND: Several TTs are available to treat mRCC; however, the optimal sequence of therapy remains unknown. PATIENTS AND METHODS: Consecutive population-based samples of patients with mRCC treated with TT were collected from 12 cancer centers via the International Metastatic Renal Cell Carcinoma Database Consortium. Patient characteristics, first-line and second-line progression-free survival rates and overall survival data were collected based on sequencing of TT. Multivariable analysis was performed when there were significant differences on univariable analysis. RESULTS: A total of 2106 patients were included with a median follow-up of 36 months; 907 (43%) and 318 (15%) patients received subsequent second-line and third-line TT, respectively. Baseline characteristics were well matched among different sequences apart from more patients with non-clear-cell histology in the vascular endothelial growth factor (VEGF) to mammalian target of rapamycin (mTOR) group compared with the VEGF to VEGF group sequence. When adjusting for the Heng risk criteria and non-clear-cell histology, the hazard ratio for death for the VEGF to mTOR group versus the VEGF to VEGF group was 0.833 (95% confidence interval [CI], 0.669-1.037; P = .1016). More specifically, the adjusted hazard ratio for death for the sunitinib to everolimus versus sunitinib to temsirolimus sequences was 0.774 (95% CI, 0.52-1.153; P = .2086). CONCLUSION: In this large multicenter analysis evaluating different sequences of TT in mRCC, no substantial effect on outcome based on sequence of TT was identified.
BACKGROUND: Several TTs are available to treat mRCC; however, the optimal sequence of therapy remains unknown. PATIENTS AND METHODS: Consecutive population-based samples of patients with mRCC treated with TT were collected from 12 cancer centers via the International Metastatic Renal Cell Carcinoma Database Consortium. Patient characteristics, first-line and second-line progression-free survival rates and overall survival data were collected based on sequencing of TT. Multivariable analysis was performed when there were significant differences on univariable analysis. RESULTS: A total of 2106 patients were included with a median follow-up of 36 months; 907 (43%) and 318 (15%) patients received subsequent second-line and third-line TT, respectively. Baseline characteristics were well matched among different sequences apart from more patients with non-clear-cell histology in the vascular endothelial growth factor (VEGF) to mammalian target of rapamycin (mTOR) group compared with the VEGF to VEGF group sequence. When adjusting for the Heng risk criteria and non-clear-cell histology, the hazard ratio for death for the VEGF to mTOR group versus the VEGF to VEGF group was 0.833 (95% confidence interval [CI], 0.669-1.037; P = .1016). More specifically, the adjusted hazard ratio for death for the sunitinib to everolimus versus sunitinib to temsirolimus sequences was 0.774 (95% CI, 0.52-1.153; P = .2086). CONCLUSION: In this large multicenter analysis evaluating different sequences of TT in mRCC, no substantial effect on outcome based on sequence of TT was identified.
Authors: Michael K Wong; Howard L Kaufman; Gregory A Daniels; David F McDermott; Sandra Aung; James N Lowder; Michael A Morse Journal: J Immunother Cancer Date: 2014-06-18 Impact factor: 13.751
Authors: Radek Lakomy; Alexandr Poprach; Zbynek Bortlicek; Bohuslav Melichar; Renata Chloupkova; Rostislav Vyzula; Milada Zemanova; Katerina Kopeckova; Marek Svoboda; Ondrej Slaby; Igor Kiss; Hana Studentova; Jaroslav Juracek; Ondrej Fiala; Jindrich Kopecky; Jindrich Finek; Ladislav Dusek; Karel Hejduk; Tomas Buchler Journal: BMC Cancer Date: 2017-12-21 Impact factor: 4.430