519 Background: Though targeted agents have dramatically changed the outcome of metastatic renal cell cancer (mRCC) patients, it has not been possible to show any survival advantage, probably due to substantial cross-over in randomized trials. The change in survival times following the introduction of targeted agents may yield indirect evidence of an improvement in overall survival (OS). Methods: First targeted agents were available in Turkey in 2007. Data from the hospital charts of adult mRCC patients treated between January 2003 and December 2012 were included. Demographic and clinical findings along with patient, tumor, and treatment-related prognostic factors and their correlation with progression-free survival (PFS), and OS were analyzed. Results: One hundred and seventy six patients had metastatic disease. Of these, 107 patients received at least one dose of interferon-α and 74 patients received at least one targeted therapy. Median follow-up was 19.1 months (range 1-97 months) and median OS was 24.6 months (95% CI, 20.4-28.9). Median OS of patients who received any targeted therapy was significantly better than those who did not (29.1 mths [95% CI, 21.4-36.8] vs 19.4 mths [95% CI, 14.2-24.6]; p=0.036). The study period of 2003-2012 was subdivided into 4 consecutive groups. Although not statistically significant, a trend toward better survival was observed with advancing years and increasing targeted therapy use (p=0.09). For example, median OS of patients diagnosed in 2006 and 2007 was 14.1 months (95% CI, 10.4-17.8) while median OS of those diagnosed in 2010 or later was 30.8 months (95% CI, 18.3-43.3). Patients in intermediate and poor Memorial Sloan-Kettering Cancer Center risk groups benefited more from targeted therapies (p=0.001). Conclusions: Patients who received any targeted therapy lived longer than those who did not. Trend toward better survival was associated with advancing years and increasing targeted therapy use. The introduction of targeted agents appear to benefit mRCC patients in terms of OS as well.
Updated recommendation on molecular-targeted therapy for metastatic renal cell cancer