Epidemiologic Trends in Renal Cell Carcinoma in the Cytokine and Post-Cytokine Eras: A Registry Analysis of 28,252 Patients

Shek, D. W.; Tomlinson, Benjamin; Brown, Monica; Brunson, Ann; Pan, Chong‐Xian; Lara, Primo N.

doi:10.1016/j.clgc.2012.01.007

Cited by 35 publications

(26 citation statements)

References 16 publications

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“…The optimization of the disease management should be based on clinical trials but also on real experiences (Schmidinger et al, 2013). Such registries, also known as “real world” or “real life” studies, providing insights into treatment patterns and outcomes, are emerging as a crucial tool for the clinicians because of a major reproducibility compared with randomized trials (Shek et al, 2012; Ta et al, 2013; Vaishampayan et al, 2014). …”

Section: Discussionmentioning

confidence: 99%

Pazopanib in Metastatic Renal Cancer: A “Real-World” Experience at National Cancer Institute “Fondazione G. Pascale”

et al. 2016

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Pazopanib is an oral angiogenesis inhibitor, currently approved for treatment of metastatic renal cell carcinoma (mRCC) and soft tissue sarcoma. The present study analyzed the outcomes of pazopanib in first-line treatment of mRCC, in a single Italian cancer center. In the light of the retrospective, observational nature and the unselected population, our experience can be defined a “real-world” study. The medical records of 38 mRCC patients treated with front-line pazopanib were retrospectively reviewed and analyzed. The progression free survival (PFS) and the overall survival (OS) were the primary endpoints, while secondary objectives included objective response rate (ORR), disease control rate (DCR), and treatment tolerability. Pazopanib achieved a median PFS (mPFS) of 12.7 months (95% CI, 6.9–18.5 months). The median OS (mOS) was 26.2 months (95% CI, 12.6–39.9 months); the observed ORR and DCR were 30.3 and 72.7%, respectively, with a median duration of response of 11 weeks. mPFS appeared not to be influenced by number of co-morbidities (< 3 vs. ≥3), gender, Fuhrman grade and age. Conversely, the ORR and the DCR positively affect the mPFS (HR = 0.05 [95% CI, 0.05–0.55], p = 0.01; HR = 0.10 [95% CI, 0.02–0.43], p = 0.002, respectively). A worse outcome was associated with a lower mPFS in patients with liver metastases (p = 0.2) and with a high tumor burden (number of metastatic sites < 6 vs. ≥6) (p = 0.08). Worst OS was observed in patients aged ≥70 years old (HR = 6.91 [95% CI, 1.49–31.91], p = 0.01). The treatment was well-tolerated: no grade 4 adverse events, nor discontinuation due to toxicities was reported. Grade 3 hypertension affected positively the OS reaching the statistical significance (HR = 0.22 [95% CI, 0.05–0.8], p = 0.03). Thyroid dysfunction (hypo and hyperthyroidism) seems to correlate with better outcome in terms of a longer mPFS (HR = 0.12 [95% CI, 0.02–0.78], p = 0.02). Our results are consistent with those reported in prospective phase III trials and the published retrospective “real world” experiences. This analysis confirms the safety and efficacy of pazopanib in first-line setting, both in frail patients with multiple co-morbidities and Karnofsky PS < 80% and in younger, healthier patients with a number of metastatic sites < 6.

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Section: Discussionmentioning

confidence: 99%

Pazopanib in Metastatic Renal Cancer: A “Real-World” Experience at National Cancer Institute “Fondazione G. Pascale”

et al. 2016

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“…The information regarding specific therapies, histology, prognostic factors is not captured in the SEER database. A third, more recent study was reported from the California registry [17] by Shek et al and compared OS outcomes between the time periods of 1998–2003 with 2004–2007, labeled by the authors as the “cytokine” and “post-cytokine” eras respectively. Our study corroborates their findings of about a 5% improvement in 3 year OS in the “post-cytokine” era.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Targeted Therapy on Overall Survival in Advanced Renal Cancer: A Study of the National Surveillance Epidemiology and End Results Registry Database

Vaishampayan

Vankayala

Vigneau

et al. 2014

Clinical Genitourinary Cancer

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Introduction With the advent and availability of targeted therapy, the treatment of advanced/metastatic renal cell carcinoma (RCC) underwent a drastic change in 2005. The impact of this change on clinical outcome, within the population has not been studied. The aim of this study was to evaluate the overall survival (OS), prior to, and post availability of targeted therapy, for advanced RCC cases in the population-based Surveillance, Epidemiology and End Results (SEER) cancer registry. Methods All advanced (regional and distant stage) RCC cases diagnosed within the 2000–2008 time periods were included. Since SEER does not report the exact therapy, and as targeted therapy was initially approved in 2005, we evaluated and compared the OS outcomes of advanced RCC cases diagnosed between the years, 2000–2003 (pre targeted therapy era) with that of those diagnosed between 2005–2008 (targeted therapy era). Results There was a significant improvement in OS for advanced RCC patients treated in the targeted therapy era (N= 12,330) compared to those treated in the pre-targeted therapy era (N=11,565) (Median OS 20 months vs. 15 months, p= 0.0006). Multivariate analysis revealed that the pre-targeted therapy time period, age over 65 years, black race, and lack of nephrectomy were predictors of a shorter OS. Conclusion In univariate and multivariate analysis, targeted therapy demonstrated improvement in OS. Increasing access to targeted therapies is likely to improve outcomes in advanced RCC.

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“…1 Approximately 20-30% of patients have metastatic disease at diagnosis, and 20-40% of the patients who undergo nephrectomy for clinically localized RCC relapse at distant sites. 2 The prognosis for patients with mRCC is extremely poor. 3 Although targeted therapies have revolutionized the treatment of mRCC, the lack of curative potential, the chronic nature of the treatment, and its side effects are clear limitations.…”

Section: Introductionmentioning

confidence: 99%

Increased Expression of Androgen Receptor mRNA in Human Renal Cell Carcinoma Cells is Associated with Poor Prognosis in Patients with Localized Renal Cell Carcinoma

Lee

Modi

et al. 2015

Journal of Urology

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Epidemiologic Trends in Renal Cell Carcinoma in the Cytokine and Post-Cytokine Eras: A Registry Analysis of 28,252 Patients

Cited by 35 publications

References 16 publications

Pazopanib in Metastatic Renal Cancer: A “Real-World” Experience at National Cancer Institute “Fondazione G. Pascale”

Pazopanib in Metastatic Renal Cancer: A “Real-World” Experience at National Cancer Institute “Fondazione G. Pascale”

The Effect of Targeted Therapy on Overall Survival in Advanced Renal Cancer: A Study of the National Surveillance Epidemiology and End Results Registry Database

Increased Expression of Androgen Receptor mRNA in Human Renal Cell Carcinoma Cells is Associated with Poor Prognosis in Patients with Localized Renal Cell Carcinoma

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