841P - Metastatic renal cell carcinoma (mRCC) treated with targeted therapies (TT) in the community setting: An Italian survey on 1238 pts

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Renal Cell Cancer
Presenter Felice Pasini
Citation Annals of Oncology (2014) 25 (suppl_4): iv280-iv304. 10.1093/annonc/mdu337
Authors F. Pasini1, A.P. Fraccon2, F. Zustovich3, C. Sacco4, F. Valcamonico5, D. Donati6, E. Durante7, M. Sorarù8, M. Nicodemo9, R. Cengarle10, P. Randisi11, C. Ogliosi12, D. Bernardi13, C. Ciccarese14, S. Zanon15, I. Martellucci16, I. Falco17, C. Mucciarini18, M. Mandara19, G. Santabarbara20
  • 1Medical Oncology, Ospedale S. Maria della Misericordia Azienda Sanitaria Local 18 Rovigo, 45100 - Rovigo/IT
  • 2Medical Oncology, Casa di Cura Polispecialistica Dott. Pederzoli Presidio Ospedaliero ULSS 22, 37019 - Peschiera Del Garda/IT
  • 3Oncologia Medica 1, Istituto Oncologico Veneto, 35128 - Padova/IT
  • 4Medical Oncology, University Hospital, Udine/IT
  • 5Medical Oncology, Spedali Civili, Brescia/IT
  • 6Medical Oncology, Ospedale, Ferrara/IT
  • 7Medical Oncology, Ospedale, Legnago/IT
  • 8Medical Oncology, Ospedale, Camposampiero/IT
  • 9Divisione Di Oncologia, Ospedale "Sacro Cuore-Don Calabria" Negrar, Verona/IT
  • 10Medical Oncology, Ospedale Carlo Poma, Mantova/IT
  • 11Medical Oncology, Ospedale, Piove di Sacco/IT
  • 12Medical Oncology, Fondazione Poliambulanza, Brescia/IT
  • 13Medical Oncology, Ospedale Ulss 10, San Donà di Piave/IT
  • 14Medical Oncology, AOUI Oncologia dU, Verona/IT
  • 15U.o. Oncologia, Ospedale Civile Vittorio Veneto, Vittorio Veneto/IT
  • 16Medical Oncology, Ospedale, Siena/IT
  • 17Medical Oncology, Ospedale, Bassano/IT
  • 18U.o. Medicina Oncologica, Ospedale Ramazzini, Carpi/IT
  • 19Medical Oncology, Ospedale, San Bonifacio/IT
  • 20Medical Oncology, Ospedale di Chioggia, Chioggia/IT

Abstract

Aim

This survey verified reproducibility in the real world of the survival data reported in the literature.

Methods

This study reviewed individual data of 1238 pts treated with TT from mid 2007 to December 2012 in 35 Italian Institutions.

Results

Median age was 66 yrs (range 24-91). Histology was clear cell (CC) (84%), with sarcomatoid component (7%), others (9%); nephrectomy was performed in 88% of the pts and 36.5% of the pts presented with ≥3 metastatic sites. PS (ECOG) was 0 in 53%, 1 in 34%, ≥2 in 9%, ne in 4% of the pts. Median OS (mOS) was 24 mo. Sunitinib (su) was the 1stline (ln) therapy (tx) in 964 pts (78%), sorafenib (so) in 152 (12%), temsirolimus (tem) in 51 (4%), others in 71 (5%). Response rate to 1st ln tx was: CR 4%, PR 31%, SD 30%, PD 28%, ne 7%. In 918 evaluable pts, MSKCC risk score was poor (10%), intermediate (46%) and good (18%). Dose reduction was required in 46%; 39% of the pts had a duration of 1st ln tx <6 mo. mOS are reported in the table. 1st ln mPFS was 9.6 mo: su 11, so 8 (su vs so p= 0.002), others 9 mo. mOS was 27 for su, 23 for so (p= NS), 15 for tem (so vs tem p= 0.009). 2nd ln tx was performed in 60% of evaluable pts; mPFS was 4.8 mo: su 7.4, so 4.3, everolimus 4.1 (su vs so vs eve p= 0.008), chemo-immunotherapy 2.5 mo. mOS from starting 2nd ln tx was 13.4 mo. 278 pts (22.5%) received ≥3 ln of tx. mOS was 43 mo: VEGFi VEGFi mTORi 43 mo (96 pts), VEGFi mTORi VEGFi 44 mo (92 pts), VEGFi VEGFi VEGFi 64 mo (41 pts), others 27 mo. At logistic regression good PS, 1st ln tx duration >6 mo, no tx interruption, no dose reduction were statistically related to execution of 2nd line tx. Cox multivariate analysis showed that execution of 2nd line tx, no dose reduction, type of drug, 1st ln duration >6 mo, CC histology, no tx interruption, MSKCC risk score, PS, type of response were statistically related to OS.

mOS (all p < 0.001)
Nephrectomy vs not 28 / 6.5
Metastatic sites ≤2 vs ≥3 31 / 18
PS 0 vs 1 vs ≥2 38.5 /18.6 / 6
CR vs PR vs SD vs PD 62.5 /39 / 29 / 7.8
Poor vs intermediate vs good MSKCC risk score 6.4 / 26 /46
Dose reduction: yes vs not 19.8 / 33.6
1st ln duration <6 mo vs >6 mo 9.1 / 36.5

Conclusions

This large survey: i) confirmed survival data for the individual drugs ii) identified predictive and prognostic factors iii) showed similar OS between the principal sequences of tx.

Disclosure

All authors have declared no conflicts of interest.