TY - JOUR
T1 - Risk of recurrence and conditional survival in complete responders treated with TKIs plus or less locoregional therapies for metastatic renal cell carcinoma
AU - Santini, Daniele
AU - Santoni, Matteo
AU - Conti, A.
AU - Procopio, Giuseppe
AU - Verzoni, Elena
AU - Galli, Luca
AU - Di Lorenzo, Giuseppe
AU - De Giorgi, Ugo
AU - De Lisi, Delia
AU - Nicodemo, M.
AU - Maruzzo, Marco
AU - Massari, Francesco
AU - Buti, Sebastiano
AU - Altobelli, Emanuela
AU - Biasco, Elisa
AU - Ricotta, Riccardo
AU - Porta, Camillo
AU - Vincenzi, Bruno
AU - Papalia, Rocco
AU - Marchetti, Paolo
AU - Burattini, L.
AU - Berardi, R.
AU - Muto, G.
AU - Montironi, Rodolfo
AU - Cascinu, Stefano
AU - Tonini, Giuseppe
PY - 2016/5/31
Y1 - 2016/5/31
N2 - PURPOSE: We retrospectively analyzed the risk of recurrence and conditional Disease-Free Survival (cDFS) in 63 patients with complete remission during treatment with tirosin kinase inhibitor (TKI), alone or with local treatment in metastatic renal cell carcinoma. RESULTS: 37% patients achieve CR with TKI alone, while 63% with additional loco-regional treatments. 49% patients recurred after CR, with a median Disease free survival of 28.2 months. Patients treated with multimodal approaches present lower rate of recurrence (40% vs 61%) and longer Disease free survival compared to patient treated with TKI alone (16.5 vs 41.9 months, p=0.039).Furthermore the rate of recurrence was higher in patients with brain (88%), pancreatic (71%) and bone metastasis (50%). Patients who continued TKI therapy after complete response had a longer disease free survival than patients who stopped therapy, although the difference was not significant (42.1 vs 25.1 months, p=0.254). 2y-cDFS was better in patients treated with multimodal treatment and who continued TKIs than the other patient arms.NS: The prognostic value of CR depends on the site where was obtained and how was obtained (with or without locoregional treatment). Cessation of TKI should be carefully considered in complete responder patients.
AB - PURPOSE: We retrospectively analyzed the risk of recurrence and conditional Disease-Free Survival (cDFS) in 63 patients with complete remission during treatment with tirosin kinase inhibitor (TKI), alone or with local treatment in metastatic renal cell carcinoma. RESULTS: 37% patients achieve CR with TKI alone, while 63% with additional loco-regional treatments. 49% patients recurred after CR, with a median Disease free survival of 28.2 months. Patients treated with multimodal approaches present lower rate of recurrence (40% vs 61%) and longer Disease free survival compared to patient treated with TKI alone (16.5 vs 41.9 months, p=0.039).Furthermore the rate of recurrence was higher in patients with brain (88%), pancreatic (71%) and bone metastasis (50%). Patients who continued TKI therapy after complete response had a longer disease free survival than patients who stopped therapy, although the difference was not significant (42.1 vs 25.1 months, p=0.254). 2y-cDFS was better in patients treated with multimodal treatment and who continued TKIs than the other patient arms.NS: The prognostic value of CR depends on the site where was obtained and how was obtained (with or without locoregional treatment). Cessation of TKI should be carefully considered in complete responder patients.
KW - Complete responder patients
KW - Conditional survival
KW - Renal cell carcinoma
KW - Risk of recurrence
KW - Tirosin kinase inhibitor
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U2 - 10.18632/oncotarget.8302
DO - 10.18632/oncotarget.8302
M3 - Article
VL - 7
SP - 33381
EP - 33390
JO - Oncotarget
JF - Oncotarget
SN - 1949-2553
IS - 22
ER -