Second-Line Treatment Outcomes After First-Line Sunitinib Therapy in Metastatic Renal Cell Carcinoma

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• 作者：Chi-Chang Chen¹ ; ^{c.chen@us.imshealth.com} ; Gregory P. Hess¹ ; ² ; Zhimei Liu³ ; Dean H. Gesme⁴ ; Sanjiv S. Agarwala⁵ ; Carlos C. Garay³ ; Jerrold W. Hill¹ ; Amy Guo³
• 关键词：Everolimus ; Metastatic renal cell carcinoma ; Sorafenib ; Temsirolimus ; Tyrosine kinase inhibitor
• 刊名：Clinical Genitourinary Cancer
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：10
• 期：4
• 页码：256-261
• 全文大小：284 K

文摘

This study was conducted to evaluate the treatment outcomes associated with common second-line targeted therapies given after first-line sunitinib for metastatic renal cell carcinoma (mRCC). The sample comprised patients with mRCC (n = 257) who were receiving second-line everolimus, sorafenib, or temsirolimus between April 1, 2008, and February 29, 2011, after first-line sunitinib treatment. The patients were followed-up from the start of second-line treatment until treatment failure (defined as advancement to a third-line therapy or to mortality) or the last observation in the medical and pharmacy databases. Treatment failure was observed in 38.5 % (n = 99) of cases: 20.2 % of patients (n = 52) advanced a line of treatment; and 18.3 % of patients (n = 47) died. Kaplan-Meier analysis indicated a statistical difference in time to treatment failure among the 3 second-line targeted therapies (log-rank test, P = .045). The estimated 1-year cumulative probabilities of treatment failure were 49.9 % for everolimus, 68.4 % for sorafenib, and 71.4 % for temsirolimus. In a multivariate Cox proportional hazards model, a higher adjusted risk of treatment failure vs. everolimus was observed for both temsirolimus (hazard ratio [HR] 2.05 [95 % CI, 1.26-3.35]; P = .004) and sorafenib (HR 1.77 [95 % CI, 1.02-3.07]; P = .043). The results of this real-world data analysis suggest that the risk of second-line treatment failure after first-line sunitinib was significantly higher with temsirolimus and sorafenib compared with everolimus.