title: Characteristics of long-term and short-term survivors of metastatic renal cell carcinoma treated with targeted therapies: results from the International mRCC Database Consortium.
abstract: BACKGROUND
  Targeted therapies improve survival in metastatic renal cell carcinoma (mRCC). However, survival patterns can be divergent, and patients at the 2 extremes of the survival spectrum need to be characterized.
  
  
  METHODS
  Data from 2161 patients included in the International mRCC Database Consortium (IMDC) were analyzed. We identified patients on the basis of their duration of survival. Long-term survival (LTS) was defined as overall survival (OS) of ≥ 4 years, and short-term survival (STS) was defined as OS of ≤ 6 months from the start of targeted therapy. Baseline characteristics, including demographic, clinicopathologic, and laboratory data, were compared between LTS and STS. Treatment response by the RECIST criteria was summarized for the 2 survival groups.
  
  
  RESULTS
  A total of 152 patients experienced LTS and 218 experienced STS. Adverse clinical and laboratory prognostic factors previously described in the IMDC prognostic model were significantly more frequent in the STS group (P < .0001). In the LTS group, 138 patients (91%) had nonprogressive disease (non-PD) as best response to first-line targeted therapy, and 56 (60%) of 94 patients who received second-line therapy had non-PD. In the STS group, only 51 patients (23%) had non-PD on first-line therapy. None of 21 the patients who received second-line therapy had non-PD as best response. In LTS, the median duration of therapy was 23.6 months (range 0.4 to 81.8+ months) for first-line therapy and 11.5 months (range 0.6 to 45.7 months) for second-line therapy, compared to 2.0 and 0.8 months for the STS group, respectively.
  
  
  CONCLUSIONS
  Baseline prognostic criteria and absence of PD after first and second-line targeted therapy may characterize long-term survival.
authors.affiliation: Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: André P
authors.initials: AP
authors.lastname: Fay
authors.affiliation: Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Wanling L
authors.initials: WL
authors.lastname: Xie
authors.affiliation: University of Ulsan College of Medicine, Asan, South Korea.
authors.forename: Jae-Lyn
authors.initials: JL
authors.lastname: Lee
authors.affiliation: Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Stanford Cancer Institute, Stanford, CA.
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Harshman
authors.affiliation: Sunnybrook Odette Cancer Center, Toronto, Ontario, Canada.
authors.forename: Georg A
authors.initials: GA
authors.lastname: Bjarnason
authors.affiliation: Princess Margaret Hospital, Toronto, Canada.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Knox
authors.affiliation: London Health Sciences Center, London, ON, Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Ernst
authors.affiliation: Queen Elizabeth II Health Sciences Center, Halifax, NS, Canada.
authors.forename: Lori
authors.initials: L
authors.lastname: Wood
authors.affiliation: Karmanos Cancer Center, Detroit, MI.
authors.forename: Ulka N
authors.initials: UN
authors.lastname: Vaishamayan
authors.affiliation: Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yuasa
authors.affiliation: National Cancer Center, Singapore.
authors.forename: Min-Han
authors.initials: MH
authors.lastname: Tan
authors.affiliation: Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sun-Young
authors.initials: SY
authors.lastname: Rha
authors.affiliation: Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Frede
authors.initials: F
authors.lastname: Donskov
authors.affiliation: University of Utah Huntsman Cancer Institute, Salt Lake City, UT.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: British Columbia Cancer Agency, Vancouver, Canada.
authors.forename: Christian K
authors.initials: CK
authors.lastname: Kollmannsberger
authors.affiliation: Cross Cancer Institute, Edmonton, AB, Canada.
authors.forename: Scott A
authors.initials: SA
authors.lastname: North
authors.affiliation: Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.
authors.forename: Brian I
authors.initials: BI
authors.lastname: Rini
authors.affiliation: Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Toni K
authors.initials: TK
authors.lastname: Choueiri
authors.affiliation: Tom Baker Cancer Center and University of Calgary, Calgary, Canada. Electronic address: daniel.heng@albertahealthservices.ca.
authors.forename: Daniel Y C
authors.initials: DY
authors.lastname: Heng
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D058990:Molecular Targeted Therapy / Q000379:methods*; D009362:Neoplasm Metastasis; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Long-term survival; Overall survival; Primary refractory disease; Prognostic factors; Renal cell carcinoma; Targeted therapies