Transition to Targeted Therapies Improved the Prognosis and Increased the Utilization of Medical Treatments among Patients with Synchronous Metastatic Renal Cell Cancer.

IF 1.6 Q4 ONCOLOGY
International Journal of Surgical Oncology Pub Date : 2021-08-12 eCollection Date: 2021-01-01 DOI:10.1155/2021/5237695
Lauri Laru, Hanna Ronkainen, Markku H Vaarala
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引用次数: 1

Abstract

Since the introduction of targeted therapies (TTs) for metastatic renal cell cancer (mRCC) in 2005, a limited amount of epidemiological data on efficacy of modern drug therapies for synchronous mRCC has been published. We present a comprehensive nationwide cohort including all cases of primarily metastasized renal cell cancer among adults diagnosed between 2005 and 2010, based on data from the Finnish Cancer Registry and patient records from treating hospitals. Applied treatment protocols and survival outcomes were analyzed. A total of 977 patients were included in the analysis; 499 patients were diagnosed between 2005 and 2007 and 478 patients were diagnosed between 2008 and 2010. The median overall survival (OS) was 8.80 months (95% confidence interval (CI): 7.60-10.02). The median OS of the patients diagnosed at the latter era was significantly better (11.1; 95% CI: 8.8-13.4 vs. 7.0; 95% CI: 5.7-8.3 months, p ≤ 0.001). A total number of 524 (53.8%) patients received drug therapy. Altogether, TTs including tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors (mTORi), and vascular endothelial growth factor inhibitor covered 331 (63.2%) of first-line treatments, whereas interferon and its combinations with chemotherapy were used for 186 (35.5%) patients. The median OS rates for TT and interferon as first-line therapy groups were 19.9 (16.9-22.8) and 14.9 (12.3-17.4) months, respectively. The OS for patients who did not receive drug therapy after cytoreductive nephrectomy was dismal. We found that the OS estimate of mRCC patients in Finland has improved since the introduction of tyrosine kinase inhibitors. However, the prognosis remains poor for frail, elderly patients with an impaired performance status.

Abstract Image

Abstract Image

向靶向治疗的过渡改善了同步转移性肾细胞癌患者的预后并增加了药物治疗的利用率。
自2005年针对转移性肾细胞癌(mRCC)引入靶向治疗(tt)以来,关于现代药物治疗同步mRCC疗效的流行病学数据有限。基于芬兰癌症登记处的数据和治疗医院的患者记录,我们提出了一个全面的全国队列研究,包括2005年至2010年间诊断的所有成人原发性转移性肾细胞癌病例。分析应用的治疗方案和生存结果。共有977例患者被纳入分析;2005年至2007年期间诊断出499名患者,2008年至2010年期间诊断出478名患者。中位总生存期(OS)为8.80个月(95%可信区间(CI): 7.60-10.02)。后一时期诊断的患者的中位OS明显更好(11.1;95% CI: 8.8-13.4 vs. 7.0;95% CI: 5.7-8.3个月,p≤0.001)。共524例(53.8%)患者接受药物治疗。总的来说,包括酪氨酸激酶抑制剂、哺乳动物雷帕霉素靶点抑制剂(mTORi)和血管内皮生长因子抑制剂在内的TTs治疗覆盖了331例(63.2%)一线治疗,而干扰素及其联合化疗用于186例(35.5%)患者。TT和干扰素作为一线治疗组的中位OS率分别为19.9(16.9-22.8)和14.9(12.3-17.4)个月。对于细胞减减性肾切除术后未接受药物治疗的患者,OS是令人沮丧的。我们发现芬兰mRCC患者的OS估计自引入酪氨酸激酶抑制剂以来有所改善。然而,对于身体虚弱、表现不佳的老年患者,预后仍然很差。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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