Clinical outcomes in patients with metastatic renal cell carcinoma receiving everolimus or temsirolimus after sunitinib.

Authors

  • Roberto Iacovelli Sapienza University of Rome; Department of Radiology, Oncology and Human Pathology, Oncology Unit B. Viale Regina Elena 324, 00161 Rome, Italy.
  • Giacomo Cartenì Oncology Unit, A. Cardarelli Hospital, Naples, Italy
  • Michele Milella Medical Oncology A, Regina Elena National Cancer Institute, Rome, Italy
  • Rossana Berardi Department of Medical Oncology, Polytechnic University of the Marche Region, Ancona, Italy
  • Giuseppe Di Lorenzo Medical Oncology, Genitourinary Cancer Section, University Federico II, Naples, Italy
  • Elena Verzoni Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • Mimma Rizzo Oncology Unit, A. Cardarelli Hospital, Naples, Italy
  • Matteo Santoni Department of Medical Oncology, Polytechnic University of the Marche Region, Ancona, Italy
  • Giuseppe Procopio Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

DOI:

https://doi.org/10.5489/cuaj.1604

Keywords:

everolimus, temsirolimus, second line, renal cell carcinoma, sunitinib

Abstract

Introduction: There are little data on the clinical activity of temsirolimus (TM) and everolimus (EV) when used as second-line therapy after sunitinib (SU) in patients with metastatic renal cellcarcinoma (mRCC).

Methods: Patients with mRCC treated with EV or TM after SU were included in this retrospective analysis. Progression-free survival (PFS), time to sequence failure (TTSF) from the start of SU to disease progression with EV/TM and overall survival (OS) were estimated using Kaplan-Meier method and compared across groups using the log-rank test. Cox proportional hazards models were applied to investigate predictors of TTSF and OS.

Results: In total, 89 patients (median age 60.0 years) were included. At baseline 43% were classified as MSKCC good-risk, 43% as intermediate-risk and 14% as poor-risk. Median OS was 36.3 months and median TTSF was 17.2 months. Sixty-five patients received SU-EV and 24 patients SU-TM. Median PFS after the second-line treatment was 4.3 months in the EV group and 3.5 months in the TM group (p = 0.63). Median TTSF was 17.0 and 18.9 months (p = 0.32) and the OS was 35.8 and 38.3 months (p = 0.73) with SU-EV and SU-TM, respectively. The prognostic role of initial MSKCC was confirmed by multivariable analysis (hazard ratio 1.76, 95% confidence interval 1.08-2.85. p = 0.023).

Conclusions: This study did not show significant differences in terms of disease control and OS between EV and TM in the second-line setting. EV remains the preferred mTOR inhibitor for the treatment of mRCC patients resistant to prior tyrosine kinase inhibitor treatment.

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Published

2014-03-11

How to Cite

Iacovelli, R., Cartenì, G., Milella, M., Berardi, R., Di Lorenzo, G., Verzoni, E., Rizzo, M., Santoni, M., & Procopio, G. (2014). Clinical outcomes in patients with metastatic renal cell carcinoma receiving everolimus or temsirolimus after sunitinib. Canadian Urological Association Journal, 8(3-4), e121–5. https://doi.org/10.5489/cuaj.1604

Issue

Section

Original Research