Clinical Research Papers:
Outcome of oligoprogressing metastatic renal cell carcinoma patients treated with locoregional therapy: a multicenter retrospective analysis
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Abstract
Daniele Santini1, Raffaele Ratta2, Francesco Pantano1, Delia De Lisi1, Marco Maruzzo3, Luca Galli4,6, Elisa Biasco4, Azzurra Farnesi4, Sebastiano Buti5, Cora Nanette Sternberg6, Linda Cerbone6, Giuseppe Di Lorenzo7, Silvia Spoto8, Michelle Sterpi1, Ugo De Giorgi9, Rossana Berardi10, Mariangela Torniai10, Andrea Camerini11, Francesco Massari12, Giuseppe Procopio2 and Giuseppe Tonini1
1 Campus Bio-Medico University of Rome, Department of Medical Oncology, Rome, Italy
2 Fondazione IRCCS, Istituto Nazionale dei Tumori, Oncology Unit 1, Milan, Italy
3 Istituto Oncologico Veneto, IOV-IRCCS, Medical Oncology 1 Unit, Padova, Italy
4 University Hospital of Pisa, Oncology Unit 2, Pisa, Italy
5 University Hospital of Parma, Medical Oncology, Parma, Italy
6 San Camillo and Forlanini Hospitals, Department of Medical Oncology, Rome, Italy
7 Department of Clinical Medicine & Surgery, Oncology Division, University Federico II, Naples, Italy
8 Campus Bio-Medico University of Rome, Department of Internal Medicine, Rome, Italy
9 IRCCS Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori, Department of Medical Oncology, Meldola, Italy
10 Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Medical Oncology Unit, Ancona, Italy
11 Versilia Hospital and Istituto Toscano Tumori, Medical Oncology, Lido di Camaiore, Italy
12 S.Orsola-Malpighi Hospital, Division of Oncology, Bologna, Italy
Correspondence to:
Delia De Lisi, email:
Keywords: metastatic renal cell carcinoma (mRCC), oligoprogression, pazopanib, sunitinib, targeted therapy
Received: April 25, 2016 Accepted: June 19, 2017 Published: August 07, 2017
Abstract
Locoregional treatment with radical intent should be considered during therapy with targeted agents in patients with metastatic renal cell carcinoma (mRCC) in order to achieve a complete response, especially in the setting of an oligo-progression in one or more metastatic sites.
We retrospectively enrolled 55 patients who experienced a disease oligo-progression after at least 6 months from the beginning of first-line therapy in one or more metastatic sites radically treated with locoregional treatments. Post-first-oligo-progression overall survival (PFOPOS) and post-first-oligo-progression free survival (PFOPFS) were evaluated.
The global median PFOPOS and PFOPFS were 37 months and 14 months respectively. Patients who continued the same therapy after a locoregional treatment on a site of progression had a significantly longer mPFOPOS compared to patients who changed therapy (39 vs 11 months, p=0.014). An advantage in mPFOPOS was also observed in patients with a Memorial Sloan-Kettering Cancer Center (MSKCC) good risk score compared to patients of the intermediate risk group (39 vs 29 months, p=0.036); patients with bone metastases had a longer mPFOPOS compared to those with visceral metastases (not reached vs 31 months, p=0.045). The only independent predictor of poor prognosis, in terms of PFOPOS at multivariate analysis (p=0.007), proved out to be change of treatment after first progression.
In this paper we aim to illustrate that continuing the same systemic therapy, after a radical locoregional treatment on a site of progression, seems to be associated with a prolongation of mPFOPOS.
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PII: 20022