Publication details

Efficacy of everolimus in second- and third-line therapy for metastatic renal cell carcinoma: A registry-based analysis

Authors

BUCHLER Tomas BORTLÍČEK Zbyněk POPRACH Alexandr KUBÁČKOVÁ Kateřina KISS Igor ZEMANOVA Milada FIALA Ondrej DUŠEK Ladislav VYZULA Rostislav MELICHAR Bohuslav

Year of publication 2014
Type Article in Periodical
Magazine / Source UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1016/j.urolonc.2013.12.007
Field Oncology and hematology
Keywords Everolimus; mTOR; Renal cell carcinoma; Tyrosine kinase inhibitors; Therapy
Description Objectives: The aim of the present study was to describe the efficacy and safety of everolimus in the treatment of metastatic renal cell carcinoma (mRCC) after administration of 1 vs. 2 prior tyrosine kinase inhibitors (TKIs). Patients and methods: A national renal information system database was used as the data source for the retrospective study. There were 483 patients who received everolimus as the second (n = 350) or the third (n = 112) targeted agent following TKIs. Results: Median progression-free survival (PFS) from the start of everolimus in the second or the third line of targeted therapy was 6.1 months for both subgroups (P = 0.863). Median total PFS from the start of the first targeted agent to progression on the third targeted agent for patients receiving 3 lines of therapy with TKI-TKI-everolimus (n = 112) and TKI-everolimus-TKI (n = 27) sequences was 28.3 months vs. 31.3 months, respectively (P = 0.16), and there was no significant difference in overall survival. PFS on everolimus was associated with PFS on previous TKIs in patients receiving 1 but not 2 previous TKIs. Only 13% of 352 patients starting targeted therapy for mRCC in 2010 had received 3 sequential targeted agents by the data cutoff in March 2013. Conclusion: PFS on everolimus correlated with PFS on TKIs in patients pretreated with 1 but not 2 TKIs. Everolimus can be deferred to the third line without loss of efficacy or increased toxicity. However, only a minority of patients with mRCC starting targeted treatment can be expected to receive third-line therapy.

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