title: Using Interferon Alfa Before Tyrosine Kinase Inhibitors May Increase Survival in Patients With Metastatic Renal Cell Carcinoma: A Turkish Oncology Group (TOG) Study.
abstract: We aimed to investigate the outcomes of interferon alfa and sequencing tyrosine kinase inhibitors (TKIs) in patients with metastatic renal cell carcinoma.
  
  
  
  This multicenter study assessing the efficacy of TKIs after interferon alfa therapy in the first-line setting in patients with metastatic renal cell carcinoma. Patients (n = 104) from 8 centers in Turkey, who had been treated with interferon alfa in the first-line setting, were included in the study. Prognostic factors were evaluated for progression-free survival (PFS).
  
  
  
  The median age of the patients was 57 years. The median PFS of the patients treated with interferon alfa in the first-line was 3.6 months. A total of 61 patients received TKIs (sunitinib, n = 58; sorafenib, n = 3) after progression while on interferon alfa. The median PFS among the TKI-treated patients was 13.2 months. In the univariate analysis for interferon alfa treatment, neutrophil and hemoglobin level, platelet count, and Karnofsky performance status were the significant factors associated with PFS. In the univariate analysis for TKI treatment, neutrophil and hemoglobin levels were the significant factors for PFS. The median total PFS of the patients who had been treated with first-line interferon alfa and second-line TKIs was 24.9 months.
  
  
  
  This study showed that first-line interferon alfa treatment before TKIs may improve the total PFS in patients with metastatic renal cell carcinoma.
authors.affiliation: Department of Medical Oncology, Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey. Electronic address: mehmetartac@yahoo.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Artaç
authors.affiliation: Department of Medical Oncology, Akdeniz University Medical Faculty, Antalya, Turkey.
authors.forename: Hasan Şenol
authors.initials: HŞ
authors.lastname: Çoşkun
authors.affiliation: Department of Medical Oncology, Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Korkmaz
authors.affiliation: Department of Medical Oncology, Süleyman Demirel University Medical Faculty, Isparta, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Koçer
authors.affiliation: Department of Medical Oncology, Marmara University Medical Faculty, Istanbul, Turkey.
authors.forename: Nazım Serdar
authors.initials: NS
authors.lastname: Turhal
authors.affiliation: Department of Medical Oncology, Bülent Ecevit University Medical Faculty, Zonguldak, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Engin
authors.affiliation: Department of Medical Oncology, Ankara University Medical Faculty, Ankara, Turkey.
authors.forename: İsa
authors.initials: İ
authors.lastname: Dede
authors.affiliation: Department of Medical Oncology, Cukurova University Medical Faculty, Adana, Turkey.
authors.forename: Semra
authors.initials: S
authors.lastname: Paydaş
authors.affiliation: Department of Medical Oncology, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Öksüzoğlu
authors.affiliation: Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Bozcuk
authors.affiliation: Department of Medical Oncology, Ankara University Medical Faculty, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demirkazık
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D016019:Survival Analysis; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D016898:Interferon-alpha; D047428:Protein Kinase Inhibitors
keywords: Cytokine therapy; Progression free survival; Sorafenib; Sunitinib; VEGF inhibitors