Categories of response to first line vascular endothelial growth factor receptor targeted therapy and overall survival in patients with metastatic renal cell carcinoma.
BACKGROUND
Sequential use of targeted therapy (TT) has improved overall survival (OS) of patients with metastatic renal cell carcinoma (mRCC). The value of objective response (OR) as compared to stable disease (SD) is unclear. We aimed to investigate OR of first-line TT and its impact on OS.


METHODS
Retrospective analysis of OS among 331 mRCC patients with a first-line assessment according to RECIST 1.0. Characteristics between objective responders (complete response [CR] or partial remission [PR]), patients with SD and non-responders (progressive disease [PD] and toxicity [Tox]) were compared with the Chi-square test and the Kruskal-Wallis test. Kaplan-Meier analysis of OS and progression-free survival (PFS). Cox model analysis of Predictors of OS .


RESULTS
Best response was CR, PR, SD, PD and Tox in 9 (2.7%), 61 (18.4%), 167 (50.5%), 80 (24.2%) and 14 (4.2%) patients respectively resulting in an OR rate of 21%. Median OS in months: CR 63.2; PR 37.6; SD 35.9; PD 14.6; TOX 22.5 (p<0.0001). Median PFS for responders was 14.8, 11.5 for patients with SD and 2.5 for non-responders (p<0.0001). Similarly median OS was 38.7, 35.9 and 15.5 (p<0.00001). Primary resistance and a first-line PFS <6months were the strongest independent predictors of OS. The achievement of OR as compared to SD did not impact OS.


CONCLUSIONS
In our cohort of unselected patients OR was not associated with superior OS as compared to SD.
Charité University Medicine Berlin, Department of Urology, Berlin, Germany. Electronic address: jonas.busch@charite.de.
Jonas
J
Busch
University Medical Center Eppendorf, Department of Oncology/Hematology/Bone Marrow Transplantation/Pneumology, Hamburg, Germany.
Christoph
C
Seidel
Charité University Medicine Berlin, Department of Urology, Berlin, Germany.
Irena
I
Goranova
Charité University Medicine Berlin, Department of Urology, Berlin, Germany.
Barbara
B
Erber
Charité University Medicine Berlin, Department of Urology, Berlin, Germany.
Robert
R
Peters
Charité University Medicine Berlin, Department of Urology, Berlin, Germany.
Frank
F
Friedersdorff
Charité University Medicine Berlin, Department of Urology, Berlin, Germany.
Ahmed
A
Magheli
Charité University Medicine Berlin, Department of Urology, Berlin, Germany.
Kurt
K
Miller
Clinic for Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
Viktor
V
Grünwald
Charité University Medicine Berlin, Department of Urology, Berlin, Germany; Humboldt Vivantes Hospital Berlin, Department of Urology, Berlin, Germany.
Steffen
S
Weikert
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000201:enzymology* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000201:enzymology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors / Q000378:metabolism*; D012189:Retrospective Studies; D016019:Survival Analysis
D040262:Receptors, Vascular Endothelial Growth Factor
Metastasis; Objective response rate; Overall survival; Renal cell carcinoma; Targeted therapy