Outcome of oligoprogressing metastatic renal cell carcinoma patients treated with locoregional therapy: a multicenter retrospective analysis

Daniele Santini, Raffaele Ratta, Francesco Pantano, Delia De Lisi, Marco Maruzzo, Luca Galli, Elisa Biasco, Azzurra Farnesi, Sebastiano Buti, Cora Nanette Sternberg, Linda Cerbone, Giuseppe Di Lorenzo, Silvia Spoto, Michelle Sterpi, Ugo De Giorgi, Rossana Berardi, Mariangela Torniai, Andrea Camerini, Francesco Massari, Giuseppe ProcopioGiuseppe Tonini

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Abstract

Locoregional treatment with radical intent should be considered during therapy with targeted agents in patients with metastatic renal cell carcinoma (mRCC) in order to achieve a complete response, especially in the setting of an oligo-progression in one or more metastatic sites. We retrospectively enrolled 55 patients who experienced a disease oligo-progression after at least 6 months from the beginning of first-line therapy in one or more metastatic sites radically treated with locoregional treatments. Post-first-oligo-progression overall survival (PFOPOS) and post-first-oligo-progression free survival (PFOPFS) were evaluated. The global median PFOPOS and PFOPFS were 37 months and 14 months respectively. Patients who continued the same therapy after a locoregional treatment on a site of progression had a significantly longer mPFOPOS compared to patients who changed therapy (39 vs 11 months, p=0.014). An advantage in mPFOPOS was also observed in patients with a Memorial Sloan-Kettering Cancer Center (MSKCC) good risk score compared to patients of the intermediate risk group (39 vs 29 months, p=0.036); patients with bone metastases had a longer mPFOPOS compared to those with visceral metastases (not reached vs 31 months, p=0.045). The only independent predictor of poor prognosis, in terms of PFOPOS at multivariate analysis (p=0.007), proved out to be change of treatment after first progression. In this paper we aim to illustrate that continuing the same systemic therapy, after a radical locoregional treatment on a site of progression, seems to be associated with a prolongation of mPFOPOS.

Original languageEnglish
Pages (from-to)100708-100716
Number of pages9
JournalOncotarget
Volume8
Issue number59
DOIs
Publication statusPublished - Nov 21 2017

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Santini, D., Ratta, R., Pantano, F., De Lisi, D., Maruzzo, M., Galli, L., Biasco, E., Farnesi, A., Buti, S., Sternberg, C. N., Cerbone, L., Di Lorenzo, G., Spoto, S., Sterpi, M., De Giorgi, U., Berardi, R., Torniai, M., Camerini, A., Massari, F., ... Tonini, G. (2017). Outcome of oligoprogressing metastatic renal cell carcinoma patients treated with locoregional therapy: a multicenter retrospective analysis. Oncotarget, 8(59), 100708-100716. https://doi.org/10.18632/oncotarget.20022