Impact of second-line targeted therapy dose intensity on metastatic renal cell carcinoma patients

Abstract Background Relative dose intensity (RDI) is a simple index for evaluation of the amount of drug administered per unit time. We retrospectively investigated prognostic impact of RDI for metastatic renal cell carcinoma (mRCC) patients treated with second-line targeted therapy. Methods We enro...

Full description

Saved in:
Bibliographic Details
Published in:Clinical genitourinary cancer 2016
Main Authors: Shirotake, Suguru, M.D., Ph.D, Yasumizu, Yota, M.D, Ito, Keiichi, M.D., Ph.D, Masunaga, Ayako, M.D, Ito, Yujiro, M.D, Miyazaki, Yasumasa, M.D, Hagiwara, Masayuki, M.D, Kanao, Kent, M.D., Ph.D, Mikami, Shuji, M.D., Ph.D, Nakagawa, Ken, M.D., Ph.D, Momma, Tetsuo, M.D., Ph.D, Masuda, Takeshi, M.D, Asano, Tomohiko, M.D., Ph.D, Oyama, Masafumi, M.D., Ph.D, Tanaka, Nobuyuki, M.D., Ph.D, Mizuno, Ryuichi, M.D., Ph.D, Oya, Mototsugu, M.D., Ph.D
Format: Article
Language:English
Subjects:
Hematology, Oncology and Palliative Medicine
Urology
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Relative dose intensity (RDI) is a simple index for evaluation of the amount of drug administered per unit time. We retrospectively investigated prognostic impact of RDI for metastatic renal cell carcinoma (mRCC) patients treated with second-line targeted therapy. Methods We enrolled 168 mRCC patients. We assessed RDI at 4 weeks since second-line targeted therapy induction. Results The median follow-up since second-line targeted therapy was 18.1 months. The median time to treatment failure (TTF) and overall survival (OS) were 4.9 and 25.4 months, respectively. In Kaplan-Meier analysis, the median OS of patients with second-line RDI < 0.7 was significantly shorter than those of RDI ≥ 0.7 (12.1 vs 31.3 months, p=0.030), respectively. In the subgroup analysis, second-line RDI was definitely prognostic in the poor-risk group of the IMDC criteria, showing second-line RDI was an independent predictor for both TTF (HR=3.6 [95% CI, 1.6-8.0], p=0.002) and OS (HR=3.1 [95% CI, 1.1-8.4], p=0.026). Also, assessing the type of second-line regimen, the multivariate analysis showed that second-line RDI was an independent prognostic indicator of TTF (HR=1.7 [95% CI, 1.0-2.9], P=0.040) and OS (HR=2.7 [95% CI, 1.3-5.7], P=0.009) in patients treated with everolimus. In this group, the median TTF and OS of patients with RDI < 0.7 were 2.4 and 11.1 months and those of RDI ≥ 0.7 were 5.3 and 25.9 months, respectively. Conclusion The results suggest that second-line RDI may be a prognostic predictor for mRCC patients treated with second-line targeted therapy, particularly in both the IMDC poor-risk group and everolimus-treated group.
ISSN:1558-7673
1938-0682
DOI:10.1016/j.clgc.2016.03.014