A population-based overview of sequences of targeted therapy in Metastatic renal cell carcinoma

Nimira Alimohamed, Jae Lyn Lee, Sandy Srinivas, Georg A. Bjarnason, Jennifer J. Knox, Mary J. Mackenzie, Lori Wood, Ulka N. Vaishampayan, Min Han Tan, Sun Young Rha, Frede Donskov, Srinivas Tantravahi, Christian Kollmannsberger, Scott North, Brian I. Rini, Toni K. Choueiri, Daniel Y.C. Heng

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Abstract

Background Several TTs are available to treat mRCC; however, the optimal sequence of therapy remains unknown. Patients and Methods Consecutive population-based samples of patients with mRCC treated with TT were collected from 12 cancer centers via the International Metastatic Renal Cell Carcinoma Database Consortium. Patient characteristics, first-line and second-line progression-free survival rates and overall survival data were collected based on sequencing of TT. Multivariable analysis was performed when there were significant differences on univariable analysis. Results A total of 2106 patients were included with a median follow-up of 36 months; 907 (43%) and 318 (15%) patients received subsequent second-line and third-line TT, respectively. Baseline characteristics were well matched among different sequences apart from more patients with non-clear-cell histology in the vascular endothelial growth factor (VEGF) to mammalian target of rapamycin (mTOR) group compared with the VEGF to VEGF group sequence. When adjusting for the Heng risk criteria and non-clear-cell histology, the hazard ratio for death for the VEGF to mTOR group versus the VEGF to VEGF group was 0.833 (95% confidence interval [CI], 0.669-1.037; P =.1016). More specifically, the adjusted hazard ratio for death for the sunitinib to everolimus versus sunitinib to temsirolimus sequences was 0.774 (95% CI, 0.52-1.153; P =.2086). Conclusion In this large multicenter analysis evaluating different sequences of TT in mRCC, no substantial effect on outcome based on sequence of TT was identified.

Original languageEnglish
Pages (from-to)e127-e131
JournalClinical Genitourinary Cancer
Volume12
Issue number4
DOIs
Publication statusPublished - 2014 Aug

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Renal Cell Carcinoma
Vascular Endothelial Growth Factor A
Population
Sirolimus
Histology
Therapeutics
Confidence Intervals
Disease-Free Survival
Survival Rate
Databases
Survival
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Urology

Cite this

Alimohamed, N., Lee, J. L., Srinivas, S., Bjarnason, G. A., Knox, J. J., Mackenzie, M. J., ... Heng, D. Y. C. (2014). A population-based overview of sequences of targeted therapy in Metastatic renal cell carcinoma. Clinical Genitourinary Cancer, 12(4), e127-e131. https://doi.org/10.1016/j.clgc.2013.12.003
Alimohamed, Nimira ; Lee, Jae Lyn ; Srinivas, Sandy ; Bjarnason, Georg A. ; Knox, Jennifer J. ; Mackenzie, Mary J. ; Wood, Lori ; Vaishampayan, Ulka N. ; Tan, Min Han ; Rha, Sun Young ; Donskov, Frede ; Tantravahi, Srinivas ; Kollmannsberger, Christian ; North, Scott ; Rini, Brian I. ; Choueiri, Toni K. ; Heng, Daniel Y.C. / A population-based overview of sequences of targeted therapy in Metastatic renal cell carcinoma. In: Clinical Genitourinary Cancer. 2014 ; Vol. 12, No. 4. pp. e127-e131.
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title = "A population-based overview of sequences of targeted therapy in Metastatic renal cell carcinoma",
abstract = "Background Several TTs are available to treat mRCC; however, the optimal sequence of therapy remains unknown. Patients and Methods Consecutive population-based samples of patients with mRCC treated with TT were collected from 12 cancer centers via the International Metastatic Renal Cell Carcinoma Database Consortium. Patient characteristics, first-line and second-line progression-free survival rates and overall survival data were collected based on sequencing of TT. Multivariable analysis was performed when there were significant differences on univariable analysis. Results A total of 2106 patients were included with a median follow-up of 36 months; 907 (43{\%}) and 318 (15{\%}) patients received subsequent second-line and third-line TT, respectively. Baseline characteristics were well matched among different sequences apart from more patients with non-clear-cell histology in the vascular endothelial growth factor (VEGF) to mammalian target of rapamycin (mTOR) group compared with the VEGF to VEGF group sequence. When adjusting for the Heng risk criteria and non-clear-cell histology, the hazard ratio for death for the VEGF to mTOR group versus the VEGF to VEGF group was 0.833 (95{\%} confidence interval [CI], 0.669-1.037; P =.1016). More specifically, the adjusted hazard ratio for death for the sunitinib to everolimus versus sunitinib to temsirolimus sequences was 0.774 (95{\%} CI, 0.52-1.153; P =.2086). Conclusion In this large multicenter analysis evaluating different sequences of TT in mRCC, no substantial effect on outcome based on sequence of TT was identified.",
author = "Nimira Alimohamed and Lee, {Jae Lyn} and Sandy Srinivas and Bjarnason, {Georg A.} and Knox, {Jennifer J.} and Mackenzie, {Mary J.} and Lori Wood and Vaishampayan, {Ulka N.} and Tan, {Min Han} and Rha, {Sun Young} and Frede Donskov and Srinivas Tantravahi and Christian Kollmannsberger and Scott North and Rini, {Brian I.} and Choueiri, {Toni K.} and Heng, {Daniel Y.C.}",
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pages = "e127--e131",
journal = "Clinical Genitourinary Cancer",
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Alimohamed, N, Lee, JL, Srinivas, S, Bjarnason, GA, Knox, JJ, Mackenzie, MJ, Wood, L, Vaishampayan, UN, Tan, MH, Rha, SY, Donskov, F, Tantravahi, S, Kollmannsberger, C, North, S, Rini, BI, Choueiri, TK & Heng, DYC 2014, 'A population-based overview of sequences of targeted therapy in Metastatic renal cell carcinoma', Clinical Genitourinary Cancer, vol. 12, no. 4, pp. e127-e131. https://doi.org/10.1016/j.clgc.2013.12.003

A population-based overview of sequences of targeted therapy in Metastatic renal cell carcinoma. / Alimohamed, Nimira; Lee, Jae Lyn; Srinivas, Sandy; Bjarnason, Georg A.; Knox, Jennifer J.; Mackenzie, Mary J.; Wood, Lori; Vaishampayan, Ulka N.; Tan, Min Han; Rha, Sun Young; Donskov, Frede; Tantravahi, Srinivas; Kollmannsberger, Christian; North, Scott; Rini, Brian I.; Choueiri, Toni K.; Heng, Daniel Y.C.

In: Clinical Genitourinary Cancer, Vol. 12, No. 4, 08.2014, p. e127-e131.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A population-based overview of sequences of targeted therapy in Metastatic renal cell carcinoma

AU - Alimohamed, Nimira

AU - Lee, Jae Lyn

AU - Srinivas, Sandy

AU - Bjarnason, Georg A.

AU - Knox, Jennifer J.

AU - Mackenzie, Mary J.

AU - Wood, Lori

AU - Vaishampayan, Ulka N.

AU - Tan, Min Han

AU - Rha, Sun Young

AU - Donskov, Frede

AU - Tantravahi, Srinivas

AU - Kollmannsberger, Christian

AU - North, Scott

AU - Rini, Brian I.

AU - Choueiri, Toni K.

AU - Heng, Daniel Y.C.

PY - 2014/8

Y1 - 2014/8

N2 - Background Several TTs are available to treat mRCC; however, the optimal sequence of therapy remains unknown. Patients and Methods Consecutive population-based samples of patients with mRCC treated with TT were collected from 12 cancer centers via the International Metastatic Renal Cell Carcinoma Database Consortium. Patient characteristics, first-line and second-line progression-free survival rates and overall survival data were collected based on sequencing of TT. Multivariable analysis was performed when there were significant differences on univariable analysis. Results A total of 2106 patients were included with a median follow-up of 36 months; 907 (43%) and 318 (15%) patients received subsequent second-line and third-line TT, respectively. Baseline characteristics were well matched among different sequences apart from more patients with non-clear-cell histology in the vascular endothelial growth factor (VEGF) to mammalian target of rapamycin (mTOR) group compared with the VEGF to VEGF group sequence. When adjusting for the Heng risk criteria and non-clear-cell histology, the hazard ratio for death for the VEGF to mTOR group versus the VEGF to VEGF group was 0.833 (95% confidence interval [CI], 0.669-1.037; P =.1016). More specifically, the adjusted hazard ratio for death for the sunitinib to everolimus versus sunitinib to temsirolimus sequences was 0.774 (95% CI, 0.52-1.153; P =.2086). Conclusion In this large multicenter analysis evaluating different sequences of TT in mRCC, no substantial effect on outcome based on sequence of TT was identified.

AB - Background Several TTs are available to treat mRCC; however, the optimal sequence of therapy remains unknown. Patients and Methods Consecutive population-based samples of patients with mRCC treated with TT were collected from 12 cancer centers via the International Metastatic Renal Cell Carcinoma Database Consortium. Patient characteristics, first-line and second-line progression-free survival rates and overall survival data were collected based on sequencing of TT. Multivariable analysis was performed when there were significant differences on univariable analysis. Results A total of 2106 patients were included with a median follow-up of 36 months; 907 (43%) and 318 (15%) patients received subsequent second-line and third-line TT, respectively. Baseline characteristics were well matched among different sequences apart from more patients with non-clear-cell histology in the vascular endothelial growth factor (VEGF) to mammalian target of rapamycin (mTOR) group compared with the VEGF to VEGF group sequence. When adjusting for the Heng risk criteria and non-clear-cell histology, the hazard ratio for death for the VEGF to mTOR group versus the VEGF to VEGF group was 0.833 (95% confidence interval [CI], 0.669-1.037; P =.1016). More specifically, the adjusted hazard ratio for death for the sunitinib to everolimus versus sunitinib to temsirolimus sequences was 0.774 (95% CI, 0.52-1.153; P =.2086). Conclusion In this large multicenter analysis evaluating different sequences of TT in mRCC, no substantial effect on outcome based on sequence of TT was identified.

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DO - 10.1016/j.clgc.2013.12.003

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VL - 12

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JF - Clinical Genitourinary Cancer

SN - 1558-7673

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