Clinical impact of targeted therapies in patients with metastatic clear-cell renal cell carcinoma
Authors Nerich V, Hugues M, Paillard MJ, Borowski L, Nai T, Stein U, Hon T, Montcuquet P, Maurina T, Mouillet G, Kleinclauss F, Pivot X, Limat S, Thiery-Vuillemin A
Received 22 October 2013
Accepted for publication 20 November 2013
Published 27 February 2014 Volume 2014:7 Pages 365—374
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 4
Virginie Nerich,1,2 Marion Hugues,1 Marie Justine Paillard,3 Laëtitia Borowski,1 Thierry Nai,1 Ulrich Stein,3 Thierry Nguyen Tan Hon,3 Philippe Montcuquet,3 Tristan Maurina,3 Guillaume Mouillet,3 François Kleinclauss,2,4 Xavier Pivot,2,3 Samuel Limat,1,2 Antoine Thiery-Vuillemin2,3
1Department of Pharmacy, University Hospital, Besançon, France; 2Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France; 3Department of Medical Oncology, 4Department of Urology, University Hospital, Besançon, France
Introduction: The aim of this retrospective clinical study was to assess, in the context of the recent evolution of systemic therapies, the potential effect of targeted therapies on overall survival (OS) of patients with metastatic clear-cell renal cell carcinoma (mccRCC) in daily practice.
Patients and methods: All consecutive patients with histologically confirmed mccRCC who received systemic therapy between January 2000 and December 2010 in two oncology treatment centers in our Franche-Comté region in eastern France were included in the analysis. The primary end point was OS. The analysis of prognostic factors was performed using a two-step approach: univariate then multivariate analysis with a stepwise Cox proportional hazards regression model.
Results: For the entire cohort of 111 patients, the median OS was 17 months (95% confidence interval [CI]; 13–22 months) and the two-year OS was 39%. Three prognostic factors were independent predictors of long survival: prior nephrectomy (hazard ratio =0.38 [0.22–0.64], P<0.0001); systemic therapy by targeted therapy (hazard ratio =0.50 [0.31–0.80], P=0.005); and lack of liver metastasis (hazard ratio =0.43 [0.22–0.82], P=0.002). Median OS was 21 months [14–29 months] for patients who received at least one targeted therapy compared with 12 months [7–15 months] for patients who were treated only by immunotherapy agents (P=0.003).
Conclusion: Our results suggest that targeted therapies are associated with improved OS in comparison with cytokines, which is in line with other publications.
Keywords: angiogenesis, immunotherapy, metastatic renal cell carcinoma, mTOR, survival, targeted therapy
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