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Poster display session

3433 - Synchronous vs metachronous metastatic disease: Impact of time to metastasis on outcome in metastatic renal cell carcinoma patients treated with targeted therapy


10 Sep 2017


Poster display session


Cytotoxic Therapy;  Renal Cell Cancer


Frede Donskov


Annals of Oncology (2017) 28 (suppl_5): v295-v329. 10.1093/annonc/mdx371


F. Donskov1, W. Xie2, J.C. Wells3, A.P. Fraccon4, F. Pasini5, C. Porta5, I. Stukalin3, J.L. Lee6, A. Bamias7, T. Yuasa8, I.D. Davis9, C. Pezaro9, R. Kanesvaran10, G.A. Bjarnason11, H. Sim12, N. Agarwal13, C.K. Kollmannsberger14, C.M. Canil15, T.K. Choueiri16, D.Y.C. Heng17

Author affiliations

  • 1 Department Of Oncology, Aarhus University Hospital, 8000 - Aarhus C/DK
  • 2 Dept. Of Biostatistics And Computational Biology, Dana-Farber Cancer Institute, 02215 - Boston/US
  • 3 Department Of Oncology, Tom Baker Cancer Center, Calgary, Calgary/CA
  • 4 Department Of Clinical And Experimental Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova/IT
  • 5 Medical Oncology, Ospedale S. Maria della Misericordia Azienda Sanitaria Local 18 Rovigo, 45100 - Rovigo/IT
  • 6 Department Of Oncology And Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seul/KP
  • 7 Clinical Therapeutics, Athens University Medical School, "Alexandra" Hospital, 11528 - Athens/GR
  • 8 Department Of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo/JP
  • 9 Medical Oncology, Monash University Eastern Health Clinical School, 3128 - Box Hill/AU
  • 10 Department Of Medical Oncology, National Cancer Centre Singapore, Singapore/SG
  • 11 Department Of Oncology, Sunnybrook Odette Cancer Center, Sunnybrook HSC, M4N 3M5 - Toronto/CA
  • 12 Department Of Oncology, Princess Margaret Hospital, M5G 2M9 - Toronto/CA
  • 13 Medical Oncology, Huntsman Cancer Institute, 84112 - Salt Lake City/US
  • 14 Department Of Oncology, British Columbia Cancer Agency, V5Z 4E6 - Vancouver/CA
  • 15 Internal Medicine, Ottawa Hospital Cancer Centre, K1H8L6 - Ottawa/CA
  • 16 Department Of Oncology, Dana-Farber Cancer Institute, Boston/US
  • 17 Department Of Oncology, Tom Baker Cancer Centre, T2N 4N2 - Calgary/CA


Abstract 3433


Patients (pts) with metastatic renal cell carcinoma (mRCC) may present with primary metastases (synchronous disease) or develop metastases during follow-up (metachronous disease). The impact of timing of metastatic disease outbreak on outcomes from targeted therapy (TKI) is unclear.


We used the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) to assess overall survival (OS) and time to treatment failure (TTF) on first line TKI, and performed Cox regression analyses comparing synchronous (metastases ≤ 3 mo of initial diagnosis of cancer) vs metachronous disease (metastasis diagnosed post initial diagnosis, evaluated by intervals >3-12 mo, >1-2 yrs, >2-7 yrs, and >7yrs).


In 7386 pts with mRCC treated with first line TKI, 3906 pts (53%) had synchronous and 3480 pts (47%) had metachronous metastases. Synchronous vs metachronous disease by intervals >3-12 mo, >1-2 yrs, >2-7 yrs, >7yrs correlated with lower age at TKI initiation (mean 61 yrs vs 61, 62, 63, 66 yrs, respectively, p 1∼2yrs638(9%)40130.2(26.7-32.5)0.84(0.76-0.94)0.0026355648.0(7.3-8.9)0.99(0.90-1.08)0.767>2∼7yrs1155(16%)72934.8(32.4-38.1)0.76(0.70-0.83)


Timing of metastases post initial RCC diagnosis impacts outcome with targeted therapy in mRCC. This may need to be taken into consideration in clinical trial designs.

Clinical trial identification

Legal entity responsible for the study

The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC)


The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC)


F. Donskov: Research funding (to institution) from Novartis, GSK and Pfizer. C. Porta: Consulting or advisory role: Novartis, Bristol-Myers Squib, Pfizer, Jannsen, Eisai, Pelefon, Ipsen, Speaker bureau: Novartis, Bristol-Myers Squib, Pfizer, Ipsen; Eisai Research funding: Pfizer. J.L. Lee: Honoraria from Pfizer and Astellas; consulting fees from Astellas; research funding from Pfizer, Bayer, Janssen, Novartis, and Exelixis. T. Yuasa: Honoraria from Astellas, Novartis, and Pfizer. I.D. Davis: Supported by an Australian National Health and Medical Research Council Practitioner Fellowship (APP1102604) and research funding from Astellas and Exelixis. C. Pezaro: Honoraria from Janssen, Pfizer, Sanofi, Novartis, and Astellas; consulting fees from Novartis; and travel and accommodation funding from Pfizer and Sanofi. R. Kanesvaran: Honoraria from Pfizer, Novartis, Bayer, Astellas, Janssen, Mundipharma, and Sanofi; research funding from Sanofi; and travel and accommodation expenses from Pfizer and Astellas. N. Agarwal: Consulting fees from Pfizer, Exelixis, Cerulean, Argos, and Medivation. C.M. Canil: Advisory Boards for Janssen, Pfizer, Astellas and Amgen; speaking fees from Janseen and Astellas and travel grants from Novartis and Janssen. T.K. Choueiri: Consulting or advisory role for Bayer, Bristol-Myers Squib (institutional), GSK, Merck, Novartis, and Pfizer; and institutional research funding from AstraZeneca, Bristol-Myers Squib, Exelixis, GSK, Merck, Novartis, Peloton Therapeutics, Pfizer, Roche/Genentech, and TRACON Pharma. D.Y.C. Heng: Advisory boards Pfizer, Novartis, Bristol-Myers Squib, Exilexis. All other authors have declared no conflicts of interest.

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