Metastatic papillary renal cell carcinoma in the era of targeted therapy - a retrospective study from three European academic centres.


Journal

Acta oncologica (Stockholm, Sweden)
ISSN: 1651-226X
Titre abrégé: Acta Oncol
Pays: England
ID NLM: 8709065

Informations de publication

Date de publication:
Mar 2019
Historique:
pubmed: 7 12 2018
medline: 12 7 2019
entrez: 4 12 2018
Statut: ppublish

Résumé

Metastatic papillary renal cell carcinoma (mPRCC) is understudied. The disease is often aggressive and specific treatment options are lacking. mPRCC patients (n = 86) referred to three academic centres in Sweden and Germany in the years 2005-2015 were retrospectively identified from medical records. Statistical analyses included Kaplan-Meier curves and calculation of Cox proportional hazards, generating hazard ratios with 95% confidence intervals. The aim of the study was to evaluate overall survival (OS) of mPRCC patients treated outside of clinical trials in the era of targeted agents (TA) and to identify clinically useful prognostic factors. Median OS of all mPRCC patients was 11.2 months. TA were used in 77% of the patients and associated with younger age and better Eastern Cooperative Oncology Group performance status (PS). Brain metastases were common (28%). Patients with synchronous or metachronous metastases had similar OS. Variables independently associated with risk of death included age ≥60 years, worse PS and ≥3 metastatic sites. The MSKCC criteria did not provide additional prognostic information. A subgroup analysis of TA-treated patients revealed an association of lymph node metastasis with risk of death in addition to the other prognostic factors. OS in mPRCC remained short in the era of targeted agents. Age, PS, and number of metastatic sites provided independent prognostic information.

Sections du résumé

BACKGROUND BACKGROUND
Metastatic papillary renal cell carcinoma (mPRCC) is understudied. The disease is often aggressive and specific treatment options are lacking.
PATIENTS AND METHODS METHODS
mPRCC patients (n = 86) referred to three academic centres in Sweden and Germany in the years 2005-2015 were retrospectively identified from medical records. Statistical analyses included Kaplan-Meier curves and calculation of Cox proportional hazards, generating hazard ratios with 95% confidence intervals. The aim of the study was to evaluate overall survival (OS) of mPRCC patients treated outside of clinical trials in the era of targeted agents (TA) and to identify clinically useful prognostic factors.
RESULTS RESULTS
Median OS of all mPRCC patients was 11.2 months. TA were used in 77% of the patients and associated with younger age and better Eastern Cooperative Oncology Group performance status (PS). Brain metastases were common (28%). Patients with synchronous or metachronous metastases had similar OS. Variables independently associated with risk of death included age ≥60 years, worse PS and ≥3 metastatic sites. The MSKCC criteria did not provide additional prognostic information. A subgroup analysis of TA-treated patients revealed an association of lymph node metastasis with risk of death in addition to the other prognostic factors.
CONCLUSION CONCLUSIONS
OS in mPRCC remained short in the era of targeted agents. Age, PS, and number of metastatic sites provided independent prognostic information.

Identifiants

pubmed: 30507262
doi: 10.1080/0284186X.2018.1537505
doi:

Substances chimiques

Antineoplastic Agents 0
Everolimus 9HW64Q8G6G
MTOR protein, human EC 2.7.1.1
TOR Serine-Threonine Kinases EC 2.7.11.1
Sunitinib V99T50803M

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

306-312

Auteurs

Maria Stenman (M)

a Department of Immunology Genetics and Pathology , Uppsala University, Rudbecklaboratoriet , Uppsala , Sweden.

Michael Staehler (M)

b Department of Urology , Ludwig-Maximilians University , Munich , Germany.

Bernadett Szabados (B)

b Department of Urology , Ludwig-Maximilians University , Munich , Germany.

Per Sandström (P)

c Department of Oncology-Pathology , Karolinska Institutet , Stockholm , Sweden.

Anna Laurell (A)

a Department of Immunology Genetics and Pathology , Uppsala University, Rudbecklaboratoriet , Uppsala , Sweden.

Magnus Lindskog (M)

a Department of Immunology Genetics and Pathology , Uppsala University, Rudbecklaboratoriet , Uppsala , Sweden.

Ulrika Harmenberg (U)

c Department of Oncology-Pathology , Karolinska Institutet , Stockholm , Sweden.

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Classifications MeSH