In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. e15065-e15065
Abstract:
e15065 Background: Sorafenib and Sunitinib are multikinase inhibitors used as first -or second-line treatment of metastaic renal cell carcinoma (mRCC). In a multi-institutional study with Japanese patients, we found that good compliance(one month relative dose intensity ≥50% in Sorafenib (Eur J Can 2011) and continuing therapy for more than one course in Sunitinib) was the most important factor in improving progression free survival (PFS) time. Because PFS has been reported to be a predictor of overall survival(OS) (Heng et al. Cancer 2011), we hypothesized that good compliance with these drugs was the most important factor contributing to positive outcomes. Here, we analyzed the clinical results in our series and determined the factors most closely associated with poor compliance of VEGF-targeted therapy. Methods: We retrospectively analyzed a database comprising 143 patients treated by Sorafenib and 69 patients by Sunitinib as both first- and second-line therapy for mRCC. Cohorts were defined by gender, eGFR, Eastern Cooperative Oncology Group Performance Status (ECOG PS), T stage, prior nephrectomy, lactate dehydrogenase level, anemia, hypercalcemia, initial oral dose, and compliance. We used the Cox regression model and logistic regression analysis to calculate the hazard ratio (HR) for univariate and multivariate analysis. Results: Median PFS and OS were 9.0 months and 30.3 months, respectively. Median PFS time of the patients with good compliance (9.1months, 95%CI; 7.1-11.0) was much better than that of the patients with poor compliance (3.0 months, 95%CI; 2.5-3.5) (p 〈 0.001), although there was no significant difference in median OS time. In multivariate analysis, good compliance together with PS and anemia became the prognostic factor to predict superior PFS. In clinical items, female (HR; 3.513, 95%CI 1.567-7.871, p=0.002), poor ECOG PS (p=0.022) and renal impairment (p=0.026) were significantly associated with poor compliance in multivariate analysis. Conclusions: We need to improve drug compliance of femalepatients and patients with poor ECOG PS and renal impairment receiving sorafenib or sunitinib for the treatment of mRCC.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.15_suppl.e15065
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
