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Vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) rechallenge for patients with metastatic renal cell carcinoma after treatment failure using both VEGFR-TKI and mTOR inhibitor

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Abstract

Purpose

To assess the efficacy of vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) rechallenge for metastatic renal cell carcinoma (mRCC) patients and to identify predictive factors for increased progression-free survival (PFS) or overall survival (OS).

Methods

The clinicopathological features, outcomes, and prognostic factors of mRCC patients who were treated with VEGFR-TKI after treatment failure using both VEGFR-TKIs and mTOR inhibitors (mTORi) were reviewed.

Results

A total of 29 eligible patients were included. Five (17 %) patients achieved partial response (PR) with a median response duration of 9.5 months (95 % CI 5.7–13.4 months), and additional 16 patients (55 %) achieved stable disease. With a median follow-up period of 19.2 months (95 % CI 18.9–19.6 months), the median PFS and OS were 3.0 months (95 % CI 1.1–4.9 months) and 4.9 months (95 % CI 2.9–6.8 months), respectively. In univariate analysis, the best response to first-line VEGFR-TKI (PR vs. non-PR, p < 0.001) and time to rechallenge (TTR, ≤12 months vs. between 12 and 24 months vs. >24 months, p = 0.005) were identified as predictive factors for longer PFS on VEGFR-TKI rechallenge. In addition, an MSKCC risk group (intermediate- vs. poor-risk group, p = 0.027), better response at first-line VEGFR-TKI (PR vs. non-PR, p = 0.003), and TTR (≤12 months vs. between 12 and 24 months vs. >24 months, p = 0.026) were identified as prognostic factors for longer OS.

Conclusions

VEGFR-TKI rechallenge may be a viable option for select metastatic RCC patients who fail both VEGFR-TKI and mTORi therapies.

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Acknowledgments

This study was supported by grants (HI12C1788, HI14C1931, HI14C1731) from the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea.

Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Inkeun Park, Jae-Lyun Lee, Jin-Hee Ahn & Dae-Ho Lee

  2. Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Jae-Lyun Lee, Jin-Hee Ahn, Dae-Ho Lee & Kyoo-Hyung Lee

  3. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Dalsan You, In Gab Jeong, Cheryn Song, Bumsik Hong, Jun Hyuk Hong & Hanjong Ahn

  4. Department of Internal Medicine, Gachon University Gil Medical Center, 1198, Guwol-Dong, Namdong-Gu, Incheon, 405-760, Korea

    Inkeun Park

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  1. Inkeun Park
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Correspondence to Jae-Lyun Lee.

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Park, I., Lee, JL., Ahn, JH. et al. Vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) rechallenge for patients with metastatic renal cell carcinoma after treatment failure using both VEGFR-TKI and mTOR inhibitor. Cancer Chemother Pharmacol 75, 1025–1035 (2015). https://doi.org/10.1007/s00280-015-2725-8

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  • DOI: https://doi.org/10.1007/s00280-015-2725-8

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