Targeted therapies used sequentially in metastatic renal cell cancer: overall results from a large experience

Abstract

Targeted therapies have improved survival in patients with metastatic renal cell cancer (RCC); however, expert opinion on the optimal therapeutic strategy is divided. This retrospective study evaluates different sequential schemes of targeted therapies in 310 patients with advanced/metastatic RCC who received different systemic agents – sorafenib, sunitinib, bevacizumab, everolimus, temsirolimus and axitinib – alone or in different sequences, until disease progression or intolerable toxicity (median follow-up: 37 months). The median overall survival (OS) was 22 months and the 5-year OS was 23.4%; differential therapeutic schemes were not associated with differences in OS. A worse performance status, no nephrectomy and a poor-risk classification according to the Motzer criteria was associated with a shorter OS. These findings support the use of targeted therapies in the treatment of RCC, even in a large unselected population from a single institution, and suggest that treatment should be tailored to meet individual circumstances and needs.

Keywords::

• mTOR inhibitors
• renal cell carcinoma
• sorafenib
• sunitinib
• targeted therapies

Financial & competing interests disclosure

Giuseppe Procopio receives honoraria from Bayer HealthCare, Pfizer, Novartis and Janssen-Cilag. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Editorial assistance for this manuscript was provided by Siobhan Ward, PhD, and Luca Giacomelli, PhD, on behalf of Content Ed Net; this assistance was funded by Bayer HealthCare.