title: Clinical impact of targeted therapies in patients with metastatic clear-cell renal cell carcinoma.
abstract: BACKGROUND
  The aim of this retrospective clinical study was to assess, in the context of the recent evolution of systemic therapies, the potential effect of targeted therapies on overall survival (OS) of patients with metastatic clear-cell renal cell carcinoma (mccRCC) in daily practice.
  
  
  METHODS
  All consecutive patients with histologically confirmed mccRCC who received systemic therapy between January 2000 and December 2010 in two oncology treatment centers in our Franche-Comté region in eastern France were included in the analysis. The primary end point was OS. The analysis of prognostic factors was performed using a two-step approach: univariate then multivariate analysis with a stepwise Cox proportional hazards regression model.
  
  
  RESULTS
  For the entire cohort of 111 patients, the median OS was 17 months (95% confidence interval [CI]; 13-22 months) and the two-year OS was 39%. Three prognostic factors were independent predictors of long survival: prior nephrectomy (hazard ratio =0.38 [0.22-0.64], P<0.0001); systemic therapy by targeted therapy (hazard ratio =0.50 [0.31-0.80], P=0.005); and lack of liver metastasis (hazard ratio =0.43 [0.22-0.82], P=0.002). Median OS was 21 months [14-29 months] for patients who received at least one targeted therapy compared with 12 months [7-15 months] for patients who were treated only by immunotherapy agents (P=0.003).
  
  
  CONCLUSIONS
  Our results suggest that targeted therapies are associated with improved OS in comparison with cytokines, which is in line with other publications.
authors.affiliation: Department of Pharmacy, University Hospital, Besançon, France ; Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Nerich
authors.affiliation: Department of Pharmacy, University Hospital, Besançon, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Hugues
authors.affiliation: Department of Medical Oncology, Besançon, France.
authors.forename: Marie Justine
authors.initials: MJ
authors.lastname: Paillard
authors.affiliation: Department of Pharmacy, University Hospital, Besançon, France.
authors.forename: Laëtitia
authors.initials: L
authors.lastname: Borowski
authors.affiliation: Department of Pharmacy, University Hospital, Besançon, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Nai
authors.affiliation: Department of Medical Oncology, Besançon, France.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stein
authors.affiliation: Department of Medical Oncology, Besançon, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Nguyen Tan Hon
authors.affiliation: Department of Medical Oncology, Besançon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Montcuquet
authors.affiliation: Department of Medical Oncology, Besançon, France.
authors.forename: Tristan
authors.initials: T
authors.lastname: Maurina
authors.affiliation: Department of Medical Oncology, Besançon, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Mouillet
authors.affiliation: Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France ; Department of Urology, University Hospital, Besançon, France.
authors.forename: François
authors.initials: F
authors.lastname: Kleinclauss
authors.affiliation: Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France ; Department of Medical Oncology, Besançon, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pivot
authors.affiliation: Department of Pharmacy, University Hospital, Besançon, France ; Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France.
authors.forename: Samuel
authors.initials: S
authors.lastname: Limat
authors.affiliation: Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France ; Department of Medical Oncology, Besançon, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Thiery-Vuillemin
keywords: angiogenesis; immunotherapy; mTOR; metastatic renal cell carcinoma; survival; targeted therapy