824P - Overall survival (OS) in metastatic renal cell carcinoma (mRCC) sequentially treated with different targeted therapies (TTs): results from a large c...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Renal Cell Cancer
Presenter Giuseppe Procopio
Authors G. Procopio1, E. Verzoni2, I. Testa2, R. Iacovelli3, E. Garanzini2, F.G.M. De Braud2
  • 1Oncologia Medica, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 2Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 3Dipartimento Di Scienze Radiologiche, Oncologiche Ed Anatomo-patologiche, Policlinico Umberto I, IT-00161 - Roma/IT

Abstract

Introduction

Targeted Therapies (TTs) have improved survival in patients with mRCC. However expert opinion on the optimal therapeutic strategy is not entirely shared. This study was performed to assess the overall survival (OS) in a consecutive series of mRCC patients receiving TTs.

Methods

Baseline characteristics and outcomes of 336 patients affected by mRCC receiving TTs were collected from the database of IRCCS Istituto Nazionale Tumori of Milan. The main characteristics of patients were: ECOG PS 0/1/2 186 (55%)/131(39%)/19 (6%); clear-cell histology 291 (87 %); previous nephrectomy 293 (87%). According to Motzer criteria 32% of patients showed low risk, 48 % intermediate and 20% had poor prognosis. Overall, 167 (50%) patients received one TTs, while 116 (34%), 42 (13%) and 11 (3.3%) received 2, 3 and 4 TTs, respectively. Altogether, 245 (73%) patients received sorafenib (So), 212 (63%) sunitinib (Su), 33 (10%) a bevacizumab regimen and 73 (22%) other TTs, including everolimus, temsirolimus and axitinib. Kaplan Meier curves were used to describe the survival of these patients according to the identified prognostic factors. The uni- and multi-variate analyses for OS were carried out by means of Cox proportional hazard regression analysis.

Results

At a median follow-up of 43 months, 199 patients (57%) had died. The median OS was 24 months (95%CI: 20.0-27.0) and the 5-year OS was 24.6 % (95%CI: 18.7-30.8). In the univariate analyses, there were no significant differences in the hazard ratios (HR) for sorafenib followed by sunitinib compared to sunitinib followed by sorafenib (HRSU−SO / SO-SU = 1.16; 95%CI: 0.57-2.33) or compared with other therapies (HROther sequential th. / SO-SU = 1.21; 95%CI: 0.78-1.88; p = 0.674). In the multivariate analysis, in terms of OS no statistical difference was reported as regards the sequence used (Su/So vs So/Su; p > 0.05) or bevacizumab regimen as compared to Su and/or So used sequentially (p > 0.05). In the uni and multivariate analysis ECOG PS, nephrectomy status, Fuhrman grade and previous cytokines treatments are independent predictive factors of outcome (p< 0.01).

Conclusions

These efficacy data suggest that TTs improve OS in mRCC without any statistical difference when using different sequences of TTs. No cross-resistance between different TTs was documented.

Disclosure

All authors have declared no conflicts of interest.