title: Study of the effectiveness of first-line treatment in renal cell carcinoma.
abstract: The emergence of novel drugs corresponds with the determination of the effectiveness of the current treatments used in clinical practice. A retrospective observational study was conducted to evaluate the effectiveness of first-line treatments and to test the influence of the prognostic factors established using the Memorial Sloan-Kettering Cancer Center (MSKCC) and the analysis of Mekhail's study for two or more metastatic sites. The primary endpoints were median progression-free survival (mPFS) and median overall survival (mOS) times. A total of 65 patients were enrolled and the mPFS and mOS of the patients treated with sunitinib (n=51) were 9.0 and 20.1 months, respectively, and for the patients treated with temsirolimus (n=14) these were 3.0 and 6.2 months, respectively. In the poor-prognosis (PP) group, a difference of 1.2 months (P=0.049) was found in mPFS depending on the first-line treatment. A difference of 4.1 months (P=0.023) was also found in mPFS when classified by histology (clear verses non-clear cell) in the sunitinib-treatment group. When stratified by the prognostic group, differences of >7 months (P<0.001) were found between the groups. Therefore, it was concluded that the effectiveness of the treatments was reduced compared to previous studies and differences were found in the PP group when classified by first-line drug and histology. Additionally, the influence of prognostic factors on OS and the value of stratifying patients using these factors have been confirmed.
authors.affiliation: Hospital Pharmacy Department, Central University Hospital of Asturias, Oviedo, Asturias 33006, Spain.
authors.forename: Alejandro J
authors.initials: AJ
authors.lastname: Sastre-Heres
authors.affiliation: Hospital Pharmacy Department, Central University Hospital of Asturias, Oviedo, Asturias 33006, Spain.
authors.forename: Miguel Alaguero
authors.initials: MA
authors.lastname: Calero
authors.affiliation: Hospital Pharmacy Department, Central University Hospital of Asturias, Oviedo, Asturias 33006, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ruiz-Sánchez
authors.affiliation: Hospital Pharmacy Department, Central University Hospital of Asturias, Oviedo, Asturias 33006, Spain.
authors.forename: María Teresa Iglesias
authors.initials: MT
authors.lastname: García
authors.affiliation: Hospital Pharmacy Department, Virgen de las Nieves Hospital, Granada 18014, Spain.
authors.forename: Miguel Angel Calleja
authors.initials: MA
authors.lastname: Hernandez
authors.affiliation: Faculty of Pharmacy, University of Granada, Granada 18071, Spain.
authors.forename: Fernando Martínez
authors.initials: FM
authors.lastname: Martínez
authors.affiliation: Faculty of Pharmacy, University of Granada, Granada 18071, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Peña-Díaz
keywords: effectiveness; prognosis; renal cell cancer; sunitinib; temsirolimus