title: Safety and efficacy of temsirolimus in heavily pretreated patients with metastatic renal cell carcinoma.
abstract: BACKGROUND
  First line treatment with temsirolimus is considered standard of care in poor risk patients with metastatic renal cell carcinoma. The role of temsirolimus in pretreated patients with any risk profile is unclear. The aim of this retrospective analysis was to investigate the impact of temsirolimus in patients who had progressed on various treatment lines.
  
  
  METHODS
  From April 2007 to July 2009, all patients who had progressed on receptor-tyrosine kinase-inhibitors, VEGF-antibodies and other agents were treated with temsirolimus (25 mg weekly). Physical examination, white blood cell count and chemistry were obtained weekly and tumor response was assessed every 12 weeks.
  
  
  RESULTS
  Thirty patients with a median age of 68 years range (44-81) received treatment with temsirolimus. Most patients were categorized intermediate risk (60%) and the majority had three or more metastatic sites (56.7%). Temsirolimus was median the fourth (range 2-5) systemic treatment line. Grade 3 and 4 toxicities were rare and consisted of anemia, thrombocytopenia and hyperglycemia. Objective remission and stable disease were achieved in 13.3% and 60% of the patients, respectively. The median progression free survival was 4.9 months (2.93-6.81 95% CI).
  
  
  CONCLUSIONS
  Temsirolimus appears feasible, safe and active in heavily pretreated patients.
authors: Clinical Division of Oncology and Cancer Centre, Department of Medicine I, Medical University of Vienna, Austria. wolfgang.lamm@meduniwien.ac.at
authors: Wolfgang
authors: W
authors: Lamm
authors: Ursula Maria
authors: UM
authors: Vogl
authors: Marija
authors: M
authors: Bojic
authors: Christoph
authors: C
authors: Zielinski
authors: Christoph
authors: C
authors: Klingler
authors: Gero
authors: G
authors: Kramer
authors: Manuela
authors: M
authors: Schmidinger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; C401859:temsirolimus; D020123:Sirolimus