scholarly journals Skeletal muscle density predicts prognosis in patients with metastatic renal cell carcinoma treated with targeted therapies

Cancer ◽  
2013 ◽  
Vol 119 (18) ◽  
pp. 3377-3384 ◽  
Author(s):  
Sami Antoun ◽  
Emilie Lanoy ◽  
Roberto Iacovelli ◽  
Laurence Albiges-Sauvin ◽  
Yohann Loriot ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Targeted Therapies ◽  
Renal Cell ◽  
Muscle Density

Skeletal muscle density as a positive predictive factor for nivolumab therapy in patients with metastatic renal cell carcinoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17107-e17107
Author(s):  
Meltem Ekenel ◽  
Murat Sari ◽  
Samil Aliyev ◽  
Mert Basaran
Keyword(s):  
Skeletal Muscle ◽  
Renal Cell Carcinoma ◽  
Adipose Tissue ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Predictive Factor ◽  
Renal Cell ◽  
Intermediate Risk ◽  
Second Line ◽  
Muscle Density

e17107 Background: Immunotherapy has shown promising clinical responses in patients with metastatic Renal Cell Carcinoma (mRCC) at second-line therapy. Since objective response rates are highly variable, it is utmost important to identify patients who may benefit from immunotherapy to avoid unnecessary adverse effects and costs. Therefore, predictive as well as prognostic markers need to be studied extensively. To our knowledge, none of the body composition measurements such as fat content or skeletal muscle density have been assessed for this purpose. The objective of the current study is to analyze whether skeletal muscle (either muscle mass or muscle density) and adipose tissue play a prognostic role in patients with mRCC who were treated with immunotherapy at second line. Methods: We retrospectively analyzed 14 patients with mRCC who were progressed after tyrosine kinase inhibitor therapy and treated with Nivolumab between March 2016 and September 2019. Skeletal muscle density (SMD), skeletal muscle and adipose tissue were assessed with computed tomography imaging. Overall Survival (OS) and Progression Free Survival (PFS) were estimated by using the Kaplan-Meier method. Results: The median OS was 13,1 months and it was strongly associated with SMD; the median OS was significantly longer in patients with high SMD compared to patients with low SMD (6,9 months vs 18,5 months; P < 0,05). Also in our analysis, SMD separated the intermediate-risk group into 2 groups with different median OS periods, ranging from 8,1 months (95% confidence interval [95% CI], 5,1 months-11,1 months) in patients with intermediate-risk Heng score and low SMD to 21,5 months (95% CI, 14 months-27 months) in patients with an intermediate-risk Heng score and high SMD. Other parameters calculated for adipose tissue or skeletal muscle did not cause any significant change in survival analysis. Conclusions: High SMD appears to be associated with improved outcome in our small patient population. It could be a predictive factor when immunotherapy, Nivolumab, is considered for therapy of mRCC patients at second line.

A contemporary update on rates and management of toxicities of targeted therapies for metastatic renal cell carcinoma

2013 ◽  
Vol 39 (4) ◽  
pp. 388-401 ◽  
Author(s):  
Ahmed Alasker ◽  
Malek Meskawi ◽  
Maxine Sun ◽  
Salima Ismail ◽  
Nawar Hanna ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Targeted Therapies ◽  
Renal Cell

Emerging Targeted Therapies in Metastatic Renal Cell Carcinoma

2011 ◽  
Vol 6 (3) ◽  
pp. 189-198 ◽  
Author(s):  
Marc R. Matrana ◽  
Bradley Atkinson ◽  
Eric Jonasch ◽  
Nizar M. Tannir
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Targeted Therapies ◽  
Renal Cell

scholarly journals Evolving Treatment Paradigm in Metastatic Renal Cell Carcinoma

2017 ◽  
pp. 319-329
Author(s):  
David M. Gill ◽  
Neeraj Agarwal ◽  
Ulka Vaishampayan
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Targeted Therapies ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Kinase Inhibitor ◽  
Checkpoint Inhibitors ◽  
Mtor Inhibitors ◽  
Treatment Paradigm

The treatment paradigm for advanced and metastatic renal cell carcinoma (mRCC) has evolved rapidly since the arrival of targeted therapies and novel immunotherapies. mRCC was previously treated only with cytokines. However, discoveries of mutations affecting the von Hippel–Lindau tumor suppressor gene (leading to increased expression of VEGF and hypoxia inducible factor/HIF-1) and of deregulations in the phosphatidylinositol-3 kinase/AKT/mTOR pathway (resulting in tumor angiogenesis, cell proliferation, and tumor growth) have led to the development of numerous targeted therapies. The U.S. Food and Drug Administration (FDA) has thus approved a total of nine targeted therapies since 2005, including VEGF tyrosine kinase inhibitors (sunitinib, pazopanib, axitinib, sorafenib, and lenvatinib), a monoclonal antibody targeting VEGF (bevacizumab), mTOR inhibitors (temsirolimus and everolimus), and a multityrosine kinase inhibitor (cabozantinib). Furthermore, the development of immune checkpoint inhibitors has again shifted the mRCC therapeutic landscape with the FDA’s approval of nivolumab. Herein, we discuss the unprecedented changes in the field of clear cell histology mRCC in both the first-line and salvage settings, and we also discuss future therapies and recommend a treatment paradigm on sequencing of these agents.

Active Smoking Is Associated With Worse Prognosis in Metastatic Renal Cell Carcinoma Patients Treated With Targeted Therapies

2019 ◽  
Vol 17 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Nils Kroeger ◽  
Haoran Li ◽  
Guillermo De Velasco ◽  
Frede Donskov ◽  
Hao-Wen Sim ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Targeted Therapies ◽  
Renal Cell ◽  
Active Smoking ◽  
Worse Prognosis

Comparative effectiveness of second-line targeted therapies for metastatic renal cell carcinoma: Analysis of two practice-based chart reviews.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15504-e15504
Author(s):  
James E. Signorovitch ◽  
Nicholas J. Vogelzang ◽  
Sumanta Kumar Pal ◽  
Peggy L. Lin ◽  
Daniel J. George ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Treatment Failure ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Targeted Therapies ◽  
Renal Cell ◽  
Chart Review ◽  
Performance Status ◽  
Cox Proportional Hazards Model ◽  
Second Line

e15504 Background: Second-line targeted therapies for metastatic renal cell carcinoma (mRCC) include mammalian target of rapamycin (mTOR) inhibitors and tyrosine kinase inhibitors (TKIs). This study aimed to compare practice-based effectiveness of these therapies in a recent chart review, and to compare findings with a previous chart review (Yang et al., 2012. ASCO). Methods: Community-based medical oncologists/hematologists (N=36) reviewed charts for ≤ 15 patients each. Included patients were aged ≥ 18 years, received a 1st-line TKI and initiated 2nd-line targeted therapy in 2010 or later. The primary outcome was time from 2nd-line initiation to treatment failure (TTF; discontinuation, physician-assessed progression, or death, whichever occurred first). TTF was compared among patients receiving 2nd-line everolimus (EVE), temsirolimus (TEM), or TKI as a class (sunitinib, sorafenib, pazopanib or axitinib), using a multivariable Cox proportional hazards model adjusting for characteristics including type of initial TKI and response, histological subtype, performance status, and sites of metastasis. Hazard ratios (HRs) for TTF were pooled with previously-reported HRs for progression-free survival (PFS) from a previous chart review in a meta-analysis. Results: A total of 138, 64 and 79 patients received 2nd-line therapy with EVE, TEM or a TKI, respectively. Mean age was 63 years, mean duration of mRCC 13.5 months, and median follow-up 6 months. After adjusting for baseline characteristics, EVE was associated with a 28% and 26% reduction in the hazard of TTF compared to TEM and TKI, respectively. Pooling both studies, EVE was associated with significantly reduced hazards of TTF compared to TEM and TKI (Table). TTF differences between TEM and TKI were not significant. Conclusions: In two retrospective chart reviews EVE was associated with consistently reduced hazards of 2nd-line treatment failure in mRCC compared to TEM and TKIs. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document