title: First-line treatment result influence second-line regimen selection in targeted therapy for metastatic renal cell carcinoma.
abstract: BACKGROUND
  Sequential treatments using various targeted-therapies have been recommended for metastatic renal cell carcinoma. However, regimen selection remains difficult when adapting to various clinical situations.
  
  
  METHODS
  From 2006 to 2012, 29 patients who received sequential targeted-therapy at our hospital were included for analysis of the treatment regimens and outcome.
  
  
  RESULTS
  Patients who used sunitinib as first-line and axitinib as second-line treatment experienced a similar second-line treatment duration, as those used the same first-line and everolimus as the second-line regimen. The first-line sunitinib treatment duration was longer in the axitinib group.
  
  
  CONCLUSIONS
  Our data showed a promising sequential treatment result using sunitinib-axitinib and sunitinib-everolimus. In patients whose first-line sunitinib treatment resulted in primary resistance, second-line everolimus was found to still contribute a fair degree of disease control. Patients who responded to first-line sunitinib could also achieved fair disease control using second-line axitinib.
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C.
authors.forename: Jian-Ri
authors.initials: JR
authors.lastname: Li
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Cheng-Kuang
authors.initials: CK
authors.lastname: Yang
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Shian-Shiang
authors.initials: SS
authors.lastname: Wang
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chuan-Shu
authors.initials: CS
authors.lastname: Chen
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Kun-Yuan
authors.initials: KY
authors.lastname: Chiu
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chen-Li
authors.initials: CL
authors.lastname: Cheng
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chi-Rei
authors.initials: CR
authors.lastname: Yang
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Hao-Chung
authors.initials: HC
authors.lastname: Ho
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C.
authors.forename: Jiunn-Liang
authors.initials: JL
authors.lastname: Ko
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan ycou@vghtc.gov.tw.
authors.forename: Yen-Chuan
authors.initials: YC
authors.lastname: Ou
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D016896:Treatment Outcome
keywords: Metastatic renal cell carcinoma; axitinib; everolimus; sorafenib; sunitinib