title: Sunitinib, pazopanib or sorafenib for the treatment of patients with late relapsing metastatic renal cell carcinoma.
abstract: OBJECTIVE
  Late recurrence of renal cell carcinoma is not a rare event. In this retrospective study we investigate the clinicopathological features and the outcome of patients treated with sorafenib, sunitinib and pazopanib for late relapsing renal cell carcinoma.
  
  
  METHODS
  Data were collected from 21 Italian centers involved in the treatment of metastatic renal cell carcinoma. Late relapse was defined as more than 5 years after initial radical nephrectomy.
  
  
  RESULTS
  A total of 2,490 patients were screened and 269 (11%) were included in the study. First line therapy was sunitinib in 190 patients (71%), sorafenib in 58 (21%) and pazopanib in 21 (8%). Median progression-free survival was 20.0 months for sunitinib (95% CI 17.0-25.1), and 14.1 months for sorafenib (95% CI 11.0-29.0) and pazopanib (95% CI 11.2-not reported). On multivariate analysis MSKCC score and metastases to lymph nodes, liver and brain were associated with worst overall survival, while pancreatic metastases were associated with longer survival. Furthermore, age, MSKCC score and brain metastases were associated with worst progression-free survival.
  
  
  CONCLUSIONS
  Patients with late relapsing renal cell carcinoma seem to present a characteristic pattern of metastatic spread without showing significant differences in terms of progression-free survival among sorafenib, sunitinib and pazopanib.
authors.affiliation: Clinica di Oncologia Medica, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy. Electronic address: mattymo@alice.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.affiliation: Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Clinica di Urologia, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Conti
authors.affiliation: Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy.
authors.forename: Camillo
authors.initials: C
authors.lastname: Porta
authors.affiliation: Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
authors.affiliation: Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy.
authors.forename: Cora N
authors.initials: CN
authors.lastname: Sternberg
authors.affiliation: Medical Oncology 1, Istituto Oncologico Veneto, IRCCS, Padova, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Basso
authors.affiliation: IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori-I.R.S.T., Meldola (FC), Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: De Giorgi
authors.affiliation: Department of Oncology, Istituto Toscano Tumori, Ospedale San Donato USL-8, Arezzo, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bracarda
authors.affiliation: Department of Medical Oncology, Cardarelli Hospital, Napoli, Italy.
authors.forename: Mimma
authors.initials: M
authors.lastname: Rizzo
authors.affiliation: Oncology Foundation of Piedmont, Institute for Cancer Research and Treatment, Laboratory Medicine, Candiolo, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
authors.affiliation: Medical Oncology, 'G.B. Rossi' Academic Hospital, University of Verona, Verona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Massari
authors.affiliation: Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Iacovelli
authors.affiliation: UO Oncologia Medica 2 Universitaria Azienda Ospedaliero-Universitaria Pisana Istituto Toscano Tumori, Pisa, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Derosa
authors.affiliation: Oncology Division, Department of Oncology and Hematology, University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Masini
authors.affiliation: Medical Oncology A, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Milella
authors.affiliation: Genitourinary Cancer Section, Medical Oncology Division, Department of Endocrinology and Oncology, University Federico II, Napoli, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Lorenzo
authors.affiliation: Medical Oncology Unit, Azienda Ospedaliero Universitaria of Cagliari, Cagliari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Atzori
authors.affiliation: Department of Oncology, Oncology Unit, Azienda Ospedaliera AsMN, Istituto di Ricovero e cura a carattere scientifico, Reggio Emilia, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Pagano
authors.affiliation: Department of Oncology, University Hospital of Parma, Parma, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Buti
authors.affiliation: Medical Oncology, S. Bortolo Hospital, Vicenza, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: De Vivo
authors.affiliation: Medical Oncology, Maggiore della Carità Hospital, University of Eastern Piedmont "A. Avogadro", Novara, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mosca
authors.affiliation: S.C. Oncologia Medica, Azienda Ospedaliera di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Rossi
authors.affiliation: Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Paglino
authors.affiliation: Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Verzoni
authors.affiliation: Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy.
authors.forename: Linda
authors.initials: L
authors.lastname: Cerbone
authors.affiliation: Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Clinica di Urologia, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Muzzonigro
authors.affiliation: Division of Pancreatic and Digestive Surgery, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Falconi
authors.affiliation: Section of Pathological Anatomy, Università Politecnica delle Marche, School of Medicine, AOU Ospedali Riuniti, Ancona, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Montironi
authors.affiliation: Clinica di Oncologia Medica, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Burattini
authors.affiliation: Oncologia Medica, University Campus Bio-Medico Roma, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
authors.affiliation: Clinica di Oncologia Medica, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D007191:Indazoles; D007211:Indoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077157:Sorafenib; D013449:Sulfonamides / Q000627:therapeutic use*; D000077210:Sunitinib
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D007191:Indazoles; D007211:Indoles; D010671:Phenylurea Compounds; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D009536:Niacinamide; C516667:pazopanib; D000077157:Sorafenib; D000077210:Sunitinib
keywords: carcinoma; protein-tyrosine kinases; recurrence; renal cell; survival