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ABSTRACT: Background
Sequential inhibition of the vascular endothelial growth factor (VEGF) pathway with sorafenib could be useful for patients with metastatic renal cell carcinoma (RCC). Our aim was to determine the activity and tolerability of sorafenib as a second-line therapy in advanced RCC initially treated with a different VEGF-tyrosine kinase inhibitor (TKI).Methods
A prospective observational cohort in Mexico (2012-2019). We included 132 subjects with metastatic RCC and who had progression despite treatment with sunitinib. The primary end-point was time to disease progression as evaluated every 12-16?weeks.Results
The mean age of the cohort was 59?years (interquartile range [IQR] 50-72), 96 (73%) were men, and 48 (36%) had a favorable prognosis according to the IMDC (International Metastatic RCC Database Consortium) prognostic model. The median progression-free survival (PFS) and overall-survival after the introduction of sorafenib treatment was 8.6?months (95% confidence interval [CI]: 6.7-10.5) and 40?months (95% CI: 34.5-45.4) respectively. The median overall survival from RCC diagnosis to death was 71?months (95% CI: 58.2-83.8). On multivariable analyses, age?>?65?years was associated with a longer PFS (HR 0.51; 95% CI: 0.31-0.86; p?=?0.018). The median PFS in subjects aged >?65?years was longer compared to subjects ?65?years (14.0 [95% CI: 9.2-18.8] vs. 7.2?months [95% CI: 5.3-9.1]; p?=?0.012). Adverse events grade???3 associated with sorafenib occurred in 38 (29%) patients.Conclusion
Sequential inhibition of VEGF with sorafenib as a second-line treatment may benefit patients with metastatic RCC, especially in subjects >?65?years old.
SUBMITTER: Martin-Aguilar AE
PROVIDER: S-EPMC7786959 | biostudies-literature | 2021 Jan
REPOSITORIES: biostudies-literature
Martín-Aguilar Ana Elena AE Núñez-López Haidé H Ramirez-Sandoval Juan C JC
BMC cancer 20210105 1
<h4>Background</h4>Sequential inhibition of the vascular endothelial growth factor (VEGF) pathway with sorafenib could be useful for patients with metastatic renal cell carcinoma (RCC). Our aim was to determine the activity and tolerability of sorafenib as a second-line therapy in advanced RCC initially treated with a different VEGF-tyrosine kinase inhibitor (TKI).<h4>Methods</h4>A prospective observational cohort in Mexico (2012-2019). We included 132 subjects with metastatic RCC and who had pr ...[more]