[Experience with everolimus therapy for patients with metastatic renal cancer in Hungary].
Everolimus is indicated for the therapy of adults with advanced renal cell carcinoma after failure of treatment with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI). The aim of the study was a multicenter evaluation of efficiency and toxicity of everolimus in patients with metastatic renal carcinoma who received one line of VEGFR-TKI therapy. Data of one hundred and one patients were analyzed retrospectively. Patients received everolimus therapy between January 2010 and July 2013. Data were collected in 7 different oncology institutes in Hungary. Starting daily dose of everolimus was 10 mg in 28-day cycles. Physical and laboratory examinations were done monthly. Imaging tests were performed every 3 months. Tumor response and toxicity were evaluated according to RECIST 1.0 and NCI CTCAE 3.0, respectively. Statistical analysis was performed with SPPS version 20.0 for Windows. Currently 26 (27%) patients are being treated, 52 (54.1%) patients are alive. Median progression-free survival (PFS) was 5.7 months (95% CI 4.07-7.33). Partial remission, stable disease and progression occurred in 6 (6%), 71 (74%) and 19 (20%) patients, respectively. Median overall survival (OS) was 14.3 months (95% CI 6.99-19.81). PFS and OS results were more favorable in patients with ECOG 0-1. Survival was poorer in case of anemia, while better if PFS was longer than 12 months. In anemic patients with ECOG 0-1 and ECOG 2-3 OS was 30.9 and 7.7 months, respectively (p=0.031). Dose reduction and treatment delay happened in 8 (7.9%) and 12 (11.9%) cases, respectively. The most common side effects were the following: exanthema, edema, stomatitis, pneumonitis, anemia and abnormal kidney-, liver functions, blood sugar and cholesterol levels. According to the Hungarian experience, everolimus can safely be administered. PFS and OS results representing the centers' everyday practice, are similar to the results of the respective subgroups in the registration study.
Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary. dr.aniko.maraz@gmail.com.
Anikó
A
Maráz
Onkológiai Osztály, Egyesített Szent István és Szent László Kórház, Budapest, Hungary.
György
G
Bodoky
I. Sz. Belgyógyászati Klinika, Semmelweis Egyetem, Onkológiai Részleg, Budapest, Hungary.
Magdolna
M
Dank
C Belgyógyászati-Onkológiai és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
Lajos
L
Géczi
Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary. dr.aniko.maraz@gmail.com.
Zsuzsanna
Z
Kahán
Onkoterápiás Intézet, Pécsi Tudományegyetem Klinikai Központ, Pécs, Hungary.
László
L
Mangel
Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Miskolc, Hungary.
János
J
Révész
Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary.
Miklós
M
Szűcs
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary*; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D003875:Drug Eruptions / Q000209:etiology; D004487:Edema / Q000139:chemically induced; D000068338:Everolimus; D005260:Female; D006801:Humans; D006814:Hungary; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013280:Stomatitis / Q000139:chemically induced; D017211:Treatment Failure; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D000068338:Everolimus; D011505:Protein-Tyrosine Kinases; D020123:Sirolimus