A retrospective analysis of two different sequences of therapy lines for advanced kidney cancer.
OBJECTIVE
the ideal sequence of targeted agents for advanced kidney cancer is still unknown. In the present study we assessed the clinical benefit of two different sequential approaches, namely sorafenib, an inhibitor of mammalian target of rapamycin (mTORi) and sunitinib, or sunitinib (an mTORi) and sorafenib.


METHODS
we retrospectively reviewed the outcome of 40 advanced kidney cancer patients treated with one of the two above sequences.


RESULTS
a total of 26 patients were treated with the sequence sorafenib-mTORi-sunitinib and 14 with the sequence sunitinib-mTORi-sorafenib. The actuarial overall median progression-free survival (PFS) in the sorafenib-mTORi-sunitinib group and in the sunitinib-mTORi-sorafenib group were 21.9 and 22.8 months, respectively (log-rank test: p=0.928). In the sorafenib-mTORi-sunitinib group, patients in first-, second- and third-line therapy experienced PFS of 11.7, 5.1 and 9.1 months, respectively, while in the sunitinib-mTORi-sorafenib group PFS was 14.4, 4.3, and 3.9 months, respectively.


CONCLUSIONS
Our results suggest there is no significant difference between the two sequence modalities.
Medical Oncology, San Matteo University Hospital Foundation, Piazzale C. Golgi, 19, 27100 Pavia, Italy. c.porta@smatteo.pv.it.
Chiara
C
Paglino
Giuseppe
G
Procopio
Roberto
R
Sabbatini
Joaquim
J
Bellmunt
Manuela
M
Schmidinger
Alessandra
A
Bearz
Aristotelis
A
Bamias
Bohuslav
B
Melichar
Ilaria
I
Imarisio
Carmine
C
Tinelli
Camillo
C
Porta
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007211:Indoles / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000008:administration & dosage; D011379:Prognosis; D011758:Pyrroles / Q000008:administration & dosage; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077157:Sorafenib; D000077210:Sunitinib; D015996:Survival Rate; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors*
D007211:Indoles; D010671:Phenylurea Compounds; D011758:Pyrroles; D009536:Niacinamide; D000068338:Everolimus; D000077157:Sorafenib; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D000077210:Sunitinib; D020123:Sirolimus
Kidney cancer; drug sequence; everolimus; sorafenib; sunitinib; temisrolimus