Skeletal complications and survival in renal cancer patients with bone metastases

Woodward, Emma R.; Jagdev, Satinder; McParland, Lucy; Clark, Kathy; Gregory, Walter M.; Newsham, Alex; Rogerson, Suzanne; Hayward, Kate; Selby, Peter J.; Brown, Janet

doi:10.1016/j.bone.2010.09.008

Cited by 161 publications

(131 citation statements)

References 23 publications

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“…Bone metastases depend on complex interactions between tumor cells, osteoblasts, and osteoclasts, and they can occur in almost 35% of patients with advanced RCC or mRCC [Woodward et al 2011]. Bone metastases can be a difficult problem in advanced RCC or mRCC because of the risk of pathological fractures, hypercalcemia, spinal cord compression, and the need for narcotics to control pain.…”

Section: Bone Metastasesmentioning

confidence: 99%

Cabozantinib in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience

Ruíz-Morales

Heng

2016

Therapeutic Advances in Urology

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Abstract:The treatment of metastatic renal cell carcinoma (mRCC) is rapidly changing. During first-line treatment with targeted therapy, patients ultimately develop resistance to therapy and the disease progresses. Recently, cabozantinib has demonstrated a better response rate, progression-free survival and overall survival compared with everolimus after failure of prior targeted therapy in patients with advanced or metastatic renal cell carcinoma (RCC). Cabozantinib is a small-molecule tyrosine kinase inhibitor (TKI). It exerts inhibition of MET, vascular endothelial growth factor receptor type 2, AXL, and many other receptor tyrosine kinases that are also implicated in tumor pathobiology, including RET, KIT, and FLT3. MET drives tumor survival, invasion, angiogenesis, and metastasis through several downstream signaling pathways. AXL has recently been described as an essential mediator of cancer metastasis that mediates crosstalk and resistance to TKIs. MET and AXL are thought to be anti-vascular endothelial growth factor receptor (VEGF) resistance pathways and thus cabozantinib represents a logical choice after progression on initial VEGF therapy. Subgroup analyses examining those with good performance status or visceral and bone metastases indicate that the hazard ratios may be better when using cabozantinib versus everolimus. However, there were no clear statistically significant differences between any subgroups.

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Section: Bone Metastasesmentioning

confidence: 99%

Cabozantinib in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience

Ruíz-Morales

Heng

2016

Therapeutic Advances in Urology

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“…1 In renal cancer, bone metastases represent the second most common site of distant metastatic spread (after lung). 2 Generally, the most frequent sites are pelvis, spine and ribs. [3][4][5][6] Skeletal involvement in RCC is an aggressive, lytic process causing significant morbidity from skeletal-related events (SREs).…”

Section: Introductionmentioning

confidence: 99%

Bone metastases affect prognosis but not effectiveness of third-line targeted therapies in patients with metastatic renal cell carcinoma

Iacovelli

Santini

Rizzo

et al. 2015

CUAJ

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Introduction: Treatment of metastatic renal cell carcinoma (mRCC) has improved with the use of targeted therapies, but bone metastases continue to be negative prognostic factor. Methods: Patients with mRCC treated with everolimus (EV) or sorafenib (SO) after two previous lines of targeted therapies were included in the analysis. Overall survival (OS) and progressionfree survival (PFS) were assessed based on the presence of bone metastases and type of therapy; they were also adjusted based on prognostic criteria. Results: Of the 233 patients with mRCC, 76 had bone metastases. Of the 233 patients, EV and SO were administered in 143 and 90 patients, respectively. Median OS was 10.4 months in patients with BMs and 17.4 months in patients without bone metastases (p = 0.002). EV decreased the risk of death by 18% compared to SO (adjusted hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.74-0.91; p < 0.001), with comparable effects in patients with or without bone metastases. In the same manner, EV decreased the risk of progression by 12% compared to SO (adjusted HR 0.88, 95% CI 0.82-0.96; p = 0.002), but this difference was not significant in patients without bone metastases. The major limitations of the study are its retrospective nature, the heterogeneity of the methods to detect bone metastases, and the lack of data about patients treated with bisphosphonates. Conclusions: The relative benefit of targeted therapies in mRCC is not affected by the presence of bone metastases, but patients without bone metastases have longer response to therapy and overall survival. IntroductionThe skeleton is commonly affected by metastatic cancer. Genitourinary tumours, such as prostate and renal cell carcinoma (RCC), are particularly likely to spread to the bone. This represents the first and the fourth causes of bone metastases at post-mortem examination, with an incidence rate of 70% and 35% of cases, respectively.1 In renal cancer, bone metastases represent the second most common site of distant metastatic spread (after lung).2 Generally, the most frequent sites are pelvis, spine and ribs.3-6 Skeletal involvement in RCC is an aggressive, lytic process causing significant morbidity from skeletal-related events (SREs).3 In mRCC, SREs have been related to decreased functional independence, loss of autonomy and decreased quality of life compared with bone metastases from other tumours. During the last decade some targeted therapies have been approved for mRCC; 8 these can be classified as follows: (1) inhibitors of the vascular endothelial growth factor (VEGF) (i.e., bevacizumab in combination with interferon) or its receptor (VEGFR) (i.e., sorafenib, sunitinib, pazopanib, axitinib), and (2) mTOR inhibitors (mTORi) (i.e., temsirolimus and everolimus).Current guidelines recommend VEGF/VEGFR inhibitors as first-line therapy and temsirolimus in poor-risk patients, while there is no univocal indication for mTOR or VEGFR inhibitors as subsequent lines.9-12 Given the increasing incidence of RCC, improvements in overall surviv...

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“…Almost one third of patients present with synchronous metastatic disease and another 20% experience recurrence or develop metastatic renal cell carcinoma even after nephrectomy [19,21,22]. Bone metastasis occurs in almost 35% of patients with advanced renal cell carcinoma [19,23,24]. Skeletal involvement is commonly an aggressive large lytic process.…”

Section: Archives In Cancer Researchmentioning

confidence: 99%

Imaging of Malignant Bone Tumors

Uduma¹,

Du²,

Agwuna³

et al. 2017

Arch Can Res

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Malignant bone tumors are classified based on their predominant histological components. For example, chondrosarcoma is a tumor that consists of cartilage forming matrix. This may also translates to anticipated radiological features which will confer reasonably degree of diagnosis even prior to histology. The afore mentioned underlies our selection of some malignant bone tumors typified pictorially to buttress our reasoning.

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Skeletal complications and survival in renal cancer patients with bone metastases

Cited by 161 publications

References 23 publications

Cabozantinib in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience

Cabozantinib in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience

Bone metastases affect prognosis but not effectiveness of third-line targeted therapies in patients with metastatic renal cell carcinoma

Imaging of Malignant Bone Tumors

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