title: Long-term stable disease in metastatic renal cell carcinoma: sorafenib sequenced to sunitinib and everolimus: a case study.
abstract: Long-term stabilization of advanced renal cell carcinoma (RCC) by the sequence of sorafenib monotherapy followed by sunitinib and everolimus treatments in a man with multiple metastases is reported. A 66-year-old man was diagnosed with advanced RCC in 2005. The patient initially underwent nephrectomy, but subsequently the disease metastasized to the lung, lymph nodes, and pancreas. The patient received sorafenib 400 mg bid in a clinical trial. He experienced minimal and manageable adverse events and achieved stable disease (SD), which was maintained with sorafenib therapy for nearly 3 years before the development of liver metastases. The patient was then prescribed sunitinib, with which he also experienced SD for 1.2 years until disease progression prompted the initiation of third-line everolimus therapy, resulting in SD for another 8 months. The patient lived with stabilized RCC for 4.6 years with the use of these three sequential targeted therapies. First-line sorafenib monotherapy achieved a durable stable response and subsequent use of sunitinib and then everolimus permitted a return to SD after disease progression. The patient experienced minimal toxicity from the regimen, suggesting that it can be safely administered to elderly patients.
authors.affiliation: Internal Department III, Johannes-Gutenberg-University, Langenbeckstr. 1, 55131, Mainz, Germany. joachim.beck@3-med.klinik.uni-mainz.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Beck
authors.forename: Joaquim
authors.initials: J
authors.lastname: Bellmunt
authors.forename: Bernard
authors.initials: B
authors.lastname: Escudier
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology*; D017322:Clinical Trials, Phase II as Topic; D000068338:Everolimus; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D009536:Niacinamide / Q000031:analogs & derivatives; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000556:secondary; D010671:Phenylurea Compounds; D011725:Pyridines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077157:Sorafenib; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D007211:Indoles; D010671:Phenylurea Compounds; D011725:Pyridines; D011758:Pyrroles; D009536:Niacinamide; D000068338:Everolimus; D000077157:Sorafenib; D000077210:Sunitinib; D020123:Sirolimus