Matteo Santoni1, Alessandro Conti2, Camillo Porta3, Giuseppe Procopio4, Cora N Sternberg5, Umberto Basso6, Ugo De Giorgi7, Sergio Bracarda8, Mimma Rizzo9, Cinzia Ortega10, Francesco Massari11, Roberto Iacovelli4, Lisa Derosa12, Cristina Masini13, Michele Milella14, Giuseppe Di Lorenzo15, Francesco Atzori16, Maria Pagano17, Sebastiano Buti18, Rocco De Vivo19, Alessandra Mosca20, Marta Rossi21, Chiara Paglino3, Elena Verzoni4, Linda Cerbone5, Giovanni Muzzonigro2, Massimo Falconi22, Rodolfo Montironi23, Luciano Burattini24, Daniele Santini25, Stefano Cascinu24. 1. Clinica di Oncologia Medica, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy. Electronic address: mattymo@alice.it. 2. Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Clinica di Urologia, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy. 3. Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy. 4. Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy. 5. Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy. 6. Medical Oncology 1, Istituto Oncologico Veneto, IRCCS, Padova, Italy. 7. IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori-I.R.S.T., Meldola (FC), Italy. 8. Department of Oncology, Istituto Toscano Tumori, Ospedale San Donato USL-8, Arezzo, Italy. 9. Department of Medical Oncology, Cardarelli Hospital, Napoli, Italy. 10. Oncology Foundation of Piedmont, Institute for Cancer Research and Treatment, Laboratory Medicine, Candiolo, Italy. 11. Medical Oncology, 'G.B. Rossi' Academic Hospital, University of Verona, Verona, Italy. 12. UO Oncologia Medica 2 Universitaria Azienda Ospedaliero-Universitaria Pisana Istituto Toscano Tumori, Pisa, Italy. 13. Oncology Division, Department of Oncology and Hematology, University of Modena e Reggio Emilia, Modena, Italy. 14. Medical Oncology A, Regina Elena National Cancer Institute, Rome, Italy. 15. Genitourinary Cancer Section, Medical Oncology Division, Department of Endocrinology and Oncology, University Federico II, Napoli, Italy. 16. Medical Oncology Unit, Azienda Ospedaliero Universitaria of Cagliari, Cagliari, Italy. 17. Department of Oncology, Oncology Unit, Azienda Ospedaliera AsMN, Istituto di Ricovero e cura a carattere scientifico, Reggio Emilia, Italy. 18. Department of Oncology, University Hospital of Parma, Parma, Italy. 19. Medical Oncology, S. Bortolo Hospital, Vicenza, Italy. 20. Medical Oncology, Maggiore della Carità Hospital, University of Eastern Piedmont "A. Avogadro", Novara, Italy. 21. S.C. Oncologia Medica, Azienda Ospedaliera di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy. 22. Division of Pancreatic and Digestive Surgery, Università Politecnica delle Marche, Ancona, Italy. 23. Section of Pathological Anatomy, Università Politecnica delle Marche, School of Medicine, AOU Ospedali Riuniti, Ancona, Italy. 24. Clinica di Oncologia Medica, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy. 25. Oncologia Medica, University Campus Bio-Medico Roma, Rome, Italy.
Abstract
PURPOSE: Late recurrence of renal cell carcinoma is not a rare event. In this retrospective study we investigate the clinicopathological features and the outcome of patients treated with sorafenib, sunitinib and pazopanib for late relapsing renal cell carcinoma. MATERIALS AND METHODS: Data were collected from 21 Italian centers involved in the treatment of metastatic renal cell carcinoma. Late relapse was defined as more than 5 years after initial radical nephrectomy. RESULTS: A total of 2,490 patients were screened and 269 (11%) were included in the study. First line therapy was sunitinib in 190 patients (71%), sorafenib in 58 (21%) and pazopanib in 21 (8%). Median progression-free survival was 20.0 months for sunitinib (95% CI 17.0-25.1), and 14.1 months for sorafenib (95% CI 11.0-29.0) and pazopanib (95% CI 11.2-not reported). On multivariate analysis MSKCC score and metastases to lymph nodes, liver and brain were associated with worst overall survival, while pancreatic metastases were associated with longer survival. Furthermore, age, MSKCC score and brain metastases were associated with worst progression-free survival. CONCLUSIONS: Patients with late relapsing renal cell carcinoma seem to present a characteristic pattern of metastatic spread without showing significant differences in terms of progression-free survival among sorafenib, sunitinib and pazopanib.
PURPOSE: Late recurrence of renal cell carcinoma is not a rare event. In this retrospective study we investigate the clinicopathological features and the outcome of patients treated with sorafenib, sunitinib and pazopanib for late relapsing renal cell carcinoma. MATERIALS AND METHODS: Data were collected from 21 Italian centers involved in the treatment of metastatic renal cell carcinoma. Late relapse was defined as more than 5 years after initial radical nephrectomy. RESULTS: A total of 2,490 patients were screened and 269 (11%) were included in the study. First line therapy was sunitinib in 190 patients (71%), sorafenib in 58 (21%) and pazopanib in 21 (8%). Median progression-free survival was 20.0 months for sunitinib (95% CI 17.0-25.1), and 14.1 months for sorafenib (95% CI 11.0-29.0) and pazopanib (95% CI 11.2-not reported). On multivariate analysis MSKCC score and metastases to lymph nodes, liver and brain were associated with worst overall survival, while pancreatic metastases were associated with longer survival. Furthermore, age, MSKCC score and brain metastases were associated with worst progression-free survival. CONCLUSIONS:Patients with late relapsing renal cell carcinoma seem to present a characteristic pattern of metastatic spread without showing significant differences in terms of progression-free survival among sorafenib, sunitinib and pazopanib.
Authors: Tamara Miner Haygood; Mohamed Sayyouh; Jason Wong; Jennifer C Lin; Aurelio Matamoros; Carl Sandler; John E Madewell Journal: Sultan Qaboos Univ Med J Date: 2015-08-24