Third-line Therapy for Metastatic Renal Cell Carcinoma and Its Effect on Quality of Life and Overall Survival: A National, Multicenter, Observational Study

JOURNAL of
ONCOLOGICAL
SCIENCES

ORIGINAL RESEARCH ARTICLE

Received Date : 26 Mar 2020
Accepted Date : 23 Jun 2020
Available Online : 14 Jul 2020

Abstract Full PDF Similar Articles

İrfan ÇİÇİN^a, Aydın ÇİLTAŞ^b, Saadettin KILIÇKAP^c, Berna ÖKSÜZOĞLU^d, Doğan UNCU^e, Mehmet ARTAÇ^f, Havva YEŞİL ÇINKIR^g, Abdurrahman IŞIKDOĞAN^h, Faysal DANEⁱ, Mehmet ALİUSTAOĞLU^j, Hacı Mehmet TÜRK^k, Emin Tamer ELKIRAN^l, Erdem ÇUBUKÇU^m, Meltem EKENELⁿ, Feyyaz ÖZDEMİR^o, Ali GÖKYER^a, İlhan ÖZTOP^p, Ahmet ALACACIOĞLU^r, Hüseyin ÖZTÜRK^s, Birkan AVER^s, Metin ÖZKAN^t

^aTrakya University Faculty of Medicine, Department of Internal Medicine, Division of Oncology, Edirne, TURKEY ^bGazi University Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Ankara, TURKEY ^cHacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Ankara, TURKEY ^dDr. Abdurrahman Yurtarslan Ankara Oncology Training and Research Hospital, Department of Internal Medicine, Division of Medical Oncology, Ankara, TURKEY ^eUniversiy of Health Sciences Ankara Numune Training and Research Hospital, Clinic of Medical Oncology, Ankara, TURKEY ^fNecmettin Erbakan University Meram Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Konya, TURKEY ^gGaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Gaziantep, TURKEY ^hDicle University Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Diyarbakır, TURKEY ⁱMarmara University Pendik Training and Research Hospital, Department of Internal Medicine, Division of Medical Oncology, İstanbul, TURKEY ^jKartal Dr. Lütfi Kirdar Training and Research Hospital, Department of Medical Oncology, İstanbul, TURKEY ^kBezmialem Vakıf University Faculty of Medicine, Department of Medical Oncology, İstanbul, TURKEY ^lİnönü University Turgut Ozal Medical Center, Department of Internal Medicine, Division of Medical Oncology, Malatya, TURKEY ^mAli Osman Sönmez Oncology Hospital, Department of Medical Oncology, Bursa, TURKEY ⁿIstanbul University Istanbul Medical Faculty, Department of Medical Oncology, İstanbul, TURKEY ^oKaradeniz Technical University Faculty of Medicine, Department of Internal Medicine, Trabzon, TURKEY ^pDokuz Eylül University Faculty of Medicine, Department of Medical Oncology, İzmir, TURKEY ^rIzmir Katip Çelebi University Atatürk Training and Research Hospital, Department of Medical Oncology, İzmir, TURKEY ^sPfizer Pharmaceuticals, Medical Oncology Department, İstanbul, TURKEY ^tErciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, TURKEY

Doi: 10.37047/jos.2020-75080 - Article's Language: EN

J Oncol Sci.2020;6(2):87-95

This is an open access article under the CC BY-NC-ND license

ABSTRACT

Objective: The study aimed to evaluate the efficacy of targeted therapies used as the third-line treatment after first-line cytokine and second-line tyrosine kinase inhibitor (TKI) therapies in metastatic renal cell carcinoma (mRCC) patients and assess the quality of life (QoL) of patients. Material and Methods: This national, multicenter, non-interventional study included patients aged ≥18 years with histologically confirmed mRCC, receiving targeted therapies as the third-line treatment for the last one month. Overall survival (OS), progression-free survival (PFS), adverse events (AEs), and QoL were evaluated. Results: The study included 102 mRCC patients (74 males) (median age of 61 years). The median disease duration since diagnosis was 27.5 months (ranging 4-201 months). Of all the patients, 75.5% and 24.5% were receiving Axitinib and Everolimus, respectively, as third-line therapy. In all patients, the one-year PFS and OS rates were 62.9% and 79.9%, respectively. Seventy-one AEs (mostly mild) developed in 29 (28.4%) patients, fatigue being the most common (9.8%) AE. As compared to the baseline, no significant change was observed in the QoL scores of patients in the 12th month. The Axitinib and Everolimus groups did not differ significantly as regards to PFS and OS. Of the 11 patients with grade III-IV AEs, four were from the Everolimus group, and seven belonged to the Axitinib group. The QoL scores did not show a significant difference between the two groups except for that in the 12th month. Conclusion: Third-line therapy in mRCC patients was found to be effective and tolerable. Prolonged survival in mRCC patients receiving an increasing number of therapy lines requires further evaluation of QoL, considering it to be a part of treatment assessment.

Keywords: Clear-cell metastatic renal cell carcinoma; quality of life; survival

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