Medical Treatment of Metastatic Renal Cell Carcinoma

1980 ◽  
Vol 66 (2) ◽  
pp. 235-240 ◽  
Author(s):  
Umberto Tirelli ◽  
Sergio Frustaci ◽  
Enzo Galligioni ◽  
Andrea Veronesi ◽  
Mauro G. Trovò ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Medical Treatment ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Medical Oncology ◽  
Primary Treatment ◽  
Duration Of Response ◽  
Treatment Agent ◽  
Metastatic Rcc

Thirty five patients with metastatic RCC were observed over a 57 months period in our Division of Radiotherapy and Medical Oncology, and 30 are evaluable for this analysis. MPA was selected as primary treatment agent in 23 patients, VLB singly, in combination with MPA or in combination with CCNU was used in 1.4 and 2 patients. With MPA the TR rate was 3/23 (1 CR and 2 PR). Duration of response for the patient with CR was 6 months whereas for the patients with PR was 21 and 14 months respectively. 4 additional patients showed NC. With VLB-MPA the TR rate was 1/4 (1 PR). Duration of PR was 3 months. The median duration of survival for the 11 patients with CR, PR and NC was 14 months whereas for the 19 patients with NR was 7 months (p < 0.01). TES and TAM showed no or minimal activity as second treatment agents.

scholarly journals Targeted Therapy for Metastatic Renal Carcinoma: An Update

2014 ◽  
Vol 1 (6) ◽  
pp. 63-73 ◽  
Author(s):  
Rodrigo Donalisio da Silva ◽  
Diedra Gustafson ◽  
Leticia Nogueira ◽  
Priya N. Werahera ◽  
Wilson R Molina ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Targeted Therapy ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Target Therapy ◽  
Progression Free Survival ◽  
Primary Treatment ◽  
New Drugs ◽  
Metastatic Rcc

Conventional chemotherapy is associated with poor outcomes in metastatic renal cell carcinoma (RCC). Advances in the understanding of tumor molecular biology and the implementation of new drugs that target these molecular pathways have increased the arsenal against advanced RCC and improved outcomes in these patients. Herein, we briefly describe the latest data on targeted therapies used in the treatment of advanced renal cell carcinoma. Search strategy was performed according to PRISMA guidelines. Abstracts of relevant studies published in PubMed between 2000 and 2014 were analyzed by two authors. Abstracts were selected if they were published in English, data reported was of phase II or III clinical trials, and outcomes followed FDA approval.  If consensus between the two authors was achieved, they were included in the review. Key words used were “target therapy” and “metastatic renal cell carcinoma”. The results of the studies analyzed in this review support the benefits of targeted therapy in metastatic RCC. These include improved progression-free survival, overall survival, and quality of life as well as reduced toxicities compared to immunotherapy. The improvement in outcomes in metastatic RCC makes these drugs a preferred option as a primary treatment for these patients. 

scholarly journals Summary of the first annual Genitourinary Medical Oncology Conference Renal Cell Carcinoma Forum

2012 ◽  
Vol 1 (2S) ◽  
Author(s):  
Lori A. Wood ◽  
Bernard Escudier ◽  
Neil Reaume
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Medical Oncology ◽  
Practical Experience ◽  
Sarcomatoid Renal Cell Carcinoma

The first annual Canadian Genitourinary Medical Oncology Conference washeld in June 2006 before the Canadian Urology Association Annual Meeting.This article summarizes 3 presentations that took place as part of the Renal CellCarcinoma Forum: “Treatment of Metastatic Renal Cell Carcinoma: 2006 andBeyond” was presented by Dr. Bernard Escudier; “Practical Experience withTargeted Therapy,” by Dr. Lori Wood; and “Sarcomatoid Renal Cell Carcinoma,”by Dr. Neil Reaume.

Treatment of metastatic renal cell carcinoma with coumarin (1,2-benzopyrone) and cimetidine: a pilot study.

1987 ◽  
Vol 5 (6) ◽  
pp. 862-866 ◽  
Author(s):  
M E Marshall ◽  
L Mendelsohn ◽  
K Butler ◽  
L Riley ◽  
J Cantrell ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Pilot Study ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Renal Carcinoma ◽  
Optimal Dose ◽  
Measurable Disease ◽  
Duration Of Response ◽  
Progression Of Disease

Forty-five patients with metastatic renal cell carcinoma were treated with coumarin (1,2-benzopyrone) and cimetidine. Patients received coumarin, 100 mg orally daily; cimetidine administration, 300 mg orally four times daily, was initiated on day 15 of therapy, and treatment with both drugs was continued until progression of disease. Three patients are too early to evaluate (on study less than or equal to 2 months with no change in tumor status). Objective responses (greater than or equal to 50% reduction in measurable disease) occurred in 14 of 42 evaluable patients (33.3%) (the 95% confidence interval based on this rate is +/- 14.3%), with three complete responses and 11 partial responses (PR). Complete responses lasted 9.5, 4+, and 9.5+ months. The median duration of response for the PR group was 5 months (range, 4 to 21+ months). Twelve patients experienced stabilization of disease ranging from 4 to 16.5+ months. No response was seen in 16 patients. There was no symptomatic, hematologic, or chemical (organ dysfunction) toxicity among the 45 patients treated. Coumarin and cimetidine appear to be safe and active agents in the treatment of metastatic renal carcinoma. Further studies are required to determine the optimal dose and scheduling of these agents.

scholarly journals Sorafenib as a Second-Line Treatment in Metastatic Renal Cell Carcinoma in Mexico: A Prospective Cohort Study

2021 ◽  
Author(s):  
Ana Elena Martin-Aguilar ◽  
Haidé Nayeli Núñez-López ◽  
Juan C. Ramirez-Sandoval
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Line Treatment ◽  
Second Line ◽  
Sorafenib Treatment ◽  
Sequential Inhibition ◽  
Metastatic Rcc

Abstract Background: Sequential inhibition of the vascular endothelial growth factor (VEGF) pathway with sorafenib could be useful for patients with metastatic renal cell carcinoma (RCC). Our aim was to determine the activity and tolerability of sorafenib as a second-line therapy in advanced RCC initially treated with a different VEGF-tyrosine kinase inhibitor (TKI).Methods: A prospective observational cohort in Mexico (2012–2019). We included 132 subjects with metastatic RCC and who had progression despite treatment with sunitinib. The primary end-point was time to disease progression as evaluated every 12–16 weeks.Results: The mean age of the cohort was 59 years (interquartile range [IQR] 50-72), 96 (73%) were men, and 48 (36%) had a favorable prognosis according to the IMDC (International Metastatic RCC Database Consortium) prognostic model. The median progression-free survival (PFS) and overall-survival after the introduction of sorafenib treatment was 8.6 months (95% confidence interval [CI]: 6.7–10.5) and 40 months (95% CI: 34.5–45.4) respectively. The median overall survival from RCC diagnosis to death was 71 months (95% CI: 58.2–83.8). On multivariable analyses, age >65 years was associated with a longer PFS (HR 0.51; 95% CI: 0.31-0.86; p = 0.018). The median PFS in subjects aged >65 years was longer compared to subjects ≤65 years (14.0 [95% CI: 9.2–18.8] vs. 7.2 months [95% CI: 5.3–9.1]; p = 0.012). Adverse events grade ≥3 associated with sorafenib occurred in 38 (29%) patients.Conclusion: Sequential inhibition of VEGF with sorafenib as a second-line treatment may benefit patients with metastatic RCC, especially in subjects >65 years old.

Clinical features of metastatic renal cell carcinoma patients with intrinsic resistance to sunitinib: A Korean multicenter study.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 462-462
Author(s):  
Jung Hoon Kim ◽  
Young-Woong Won ◽  
Seung Tae Kim ◽  
Se Hoon Park ◽  
Soonil Lee ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Features ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Performance Status ◽  
Intrinsic Resistance ◽  
Distant Metastatic Disease ◽  
Resistant Disease ◽  
Metastatic Rcc

462 Background: In a subset of patients with metastatic renal cell carcinoma (RCC), primary resistance to first VEGF targeted therapy is not fully understood, and the optimal treatment approach for these patients is still controversial. This study was aimed to characterize the primary sunitinib resistant patients and associated predicting factors. Methods: A total of 134 patients with recurrent or metastatic RCC, who were initially treated with sunitinib, consecutively selected from 4 centers in Korea, between January 2008 and March 2013. Patients in whom progressive disease (PD) was the best response during treatment with sunitinib were included in the primary sunitinib resistant group. Results: Among 134 patients, 33 (25%) patients primary resistant to sunitinib with a median age of 59 years (range, 28-78) were identified. Most patients had clear cell histology (94%) and good ECOG performance status (0, 1) (82%). According to MSKCC risk, 25% of patients were at favorable risk, 72% at intermediate risk, and 3% at poor risk. Univariate analysis revealed that poor performance status (ECOG≥2), elevated LDH, neutrophilia, and higher number of distant metastatic disease (≥3) and bone or hepatic metastasis were significant factors associated with intrinsic resistant disease. Neutrophilia (OR=7.4, p=0.015) and more than three distant metastatic disease (OR=3.6, p=0.031) were independently significant risk factors of predicting intrinsic resistant disease on multivariate analysis. There was statistically significant difference with regard to overall survival (median, 11.7 vs. 31.1 month; p=0.001) and progression free survival (median, 2.4 vs. 12.5 month; p<0.0001) between the patients with and without intrinsic resistance. Conclusions: Intrinsic resistance to sunitinib treatment is associated with a dismal prognosis in metastatic RCC patients. Along with above predicting clinical features, more understanding of the underlying mechanism and molecular biomarkers for detecting the intrinsic resistant disease are needed.

Sorafenib as second-line treatment in metastatic renal cell carcinoma: A prospective cohort.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17077-e17077
Author(s):  
Ana Elena Martin Aguilar ◽  
Haidé Nayeli Núñez-López ◽  
Juan C. Carlos Ramirez-Sandoval
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Progression Free Survival ◽  
Sorafenib Treatment ◽  
Free Survival ◽  
Median Progression Free Survival ◽  
Sequential Inhibition ◽  
Metastatic Rcc

e17077 Background: Sequential inhibition of the vascular endothelial growth factor (VEGF) pathway with sorafenib could be useful for patients with advanced or metastatic renal cell carcinoma (RCC). Our aim was to determine the activity and tolerability of sorafenib as a 2nd-line therapy in advanced RCC initially treated with a different VEGF-tyrosine kinase inhibitor (TKI). Methods: Prospective observational cohort in Mexico City (July 2012 to July 2019). We included 148 subjects with metastatic RCC, treated by nephrectomy and who had RCC progression despite treatment with sunitinib (n = 144) or pazopanib (n = 4). All patients received sorafenib 400 mg orally twice a day on a continuous dosing schedule until disease progression or intolerable toxicity. The primary endpoint was time to progression evaluated every 12-16 weeks. Risk factors were classified according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC-RF) prognostic model. Results: Mean age of cohort was 58±10 years, 104 (70%) were male, 51 (35%) had none of IMDC-risk factors, and the most common sites of metastasis before sorafenib treatment were lung (n = 79, 53%) and bone (n = 30, 20%). The median progression-free survival and survival after the introduction of sorafenib treatment was 8.5 months (95% IC 6.8-10.2) and 40.1 months (95% IC 35.2-45.0) respectively. Median overall survival from RCC diagnosis to death was 71 months (95% CI 63.9-79.4). Median progression-free survival was longer in advanced RCC with none IMDC-RF compared with subjects with ≥2 IMDC-RF (10.3 [95%CI 6.1-14.6] vs 7.9 [95%CI 5.8-9.9] mo. respectively, p = 0.035). Age > 65 decreased risk of progression after sorafenib therapy (OR 0.33, 95% CI 0.14-0.77, p = 0.010). Median progression-free survival in subjects > 65 yrs old was longer (14 months, 95% CI 9.2-17.9) compared to subjects ≤65 yrs (7.2 months, 95% CI 5.5-8.9, p = 0.018). Adverse events associated to sorafenib occurred in 118 (80%) subjects: hand-foot syndrome (n = 118, 80%), diarrhea (n = 113, 76%), hypothyroidism (41, 28%), and mucositis (84, 57%). Any adverse events corresponding to a grade > 2 occurred in 48 (32%) patients. Conclusions: Sequential inhibition of VEGF with sorafenib as a 2nd-line treatment may benefit patients with metastatic RCC, especially in subjects > 65 yrs old. Further clinical trials are needed.

scholarly journals A Rare Subcutaneous Manifestation of Metastatic Renal Cell Carcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Darren Yak Leong Chan ◽  
Wei Jin Chua
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Ultrasound Imaging ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Bone Scan ◽  
Rare Case ◽  
Bone Scans ◽  
Metastatic Rcc

We report a rare case of advanced metastatic renal cell carcinoma which initially presented to the clinic with back and forehead lumps. Ultrasound imaging of the lumps and later of the abdomen picked up a right renal tumour which led to further computed tomography and bone scans. The bone scan confirmed that the forehead lump was a calvarial metastasis and such a presentation for metastatic RCC is very rare which bears a significantly poorer prognosis.

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