ONCOLOGICAL OUTCOMES OF METASTATIC RENAL CELL CARCINOMA (MRCC) WITH MOLECULAR-TARGETED THERAPY IN ASAHIKAWA MEDICAL UNIVERSITY HOSPITAL

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Abstract

Background

Since 2008, molecular-targeted therapy has been the standard systemic treatment of mRCC instead of IFN and IL-2. We have been accumulating our experience of molecular-targeted therapy for mRCC to analyze oncological outcomes. Herein, we present short-term outcomes of mRCC that was treated with molecular-targeted therapy in our institution.

Patients and methods

We retrospectively investigated oncological outcomes of 36 patients with mRCC who were treated with molecular-targeted therapy with or without nephrectomy.

Results

The median age was 66 years. Twenty-seven patients (75%) underwent nephrectomy and other 9 patients did not. Of the 27 patients who underwent nephrectomy, 24 (89%) received molecular-targeted therapy under adjuvant or salvage setting, whereas the other 3 patients received under presurgical setting. The pathological type was clear cell carcinoma in 17 patients, non-clear cell in 9 and mixed type histology in 5. The remaining five patients did not undergo primary or metastatic site biopsy. The 2- and 3-year overall survival was 53.8 and 33.6%, respectively, from initial molecular targeted therapy. All nine patients without nephrectomy died within median time of 4 months. Thirteen patients had been treated with systemic therapy with IFN or IL-2 immunotherapy before initiation of molecular-targeted therapy. Twelve patients were treated with sequential therapy, including six cases treated with sorafenib, then sunitinib, followed by everolimus, five cases treated with sorafenib followed by sunitinib or vice versa and one case treated with sunitinib followed by temsirolimus. The most common grade 3 adverse events (AEs) were fatigue (18%) and hand-foot syndrome (12%). These AEs were manageable and reversible.

Conclusions

Our experience of molecular-targeted therapy for mRCC shows favorable oncological outcomes with acceptable tolerability. Molecular-targeted therapy cannot cure mRCC but probably can prolong patient survival without compromising their quality of life.

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