An evaluation of the clinical and treatment features of renal cell carcinoma

Abstract

Renal cell carcinoma (RCC) is a significant cause of death, particularly in the elderly, and makes accounting for about 3% of all cancer cases. In kidney cancer, as in many other malignancies, treatment response and strategy are largely dependent on the prognosis at the time of diagnosis. Targeted therapies have been the subject of many studies in kidney cancer treatment in recent years. We looked into the objective response rate (ORR), overall survival (OS), progression-free survival (PFS), treatment options, adverse effects, and demographics of patients with kidney cancer in our study. Patients having a diagnosis of kidney cancer were included in the study, received tyrosine kinase inhibitor treatment, and were treated and followed up in our center between January 2005 and September 2017 at the Medical Oncology Clinic of Internal Medicine, Faculty of Medicine, Ondokuz Mayıs University. The files of these patients were analyzed retrospectively. 160 RCC patients in all who had treatment and followed up in our center were evaluated. The study included 62 patients who received tyrosine kinase inhibitors after first-line interferon in the metastatic period. The age range was 24-79 years old 24 to 79 years, with a median age of 62.7 years at the time of diagnosis. Forty-four (70.9%) patients were treated with sunitinib and 18 (29.1%) patients were treated with pazopanib in the first-line setting after metastatic interferon. PFS was 10.8 months for pazopanib and 11.4 months for sunitinib. OS was 23.6 months with for pazopanib and 25 months with for sunitinib therapy. ORR was 19% with sunitinib. Anemia was the most common hematologic adverse effect and fatigue was the most frequent non-hematologic side effect after sunitinib treatment, according to evaluations of side effects both hematological and non-hematological. according to evaluations of both hematological and non-hematological side effects. Individuals treated with sunitinib with pazopanib exhibited prolonged progression-free survival and overall survival. The results suggest that created treatments for m-RCC are successful.

Keywords

• overall survival
• kidney cell cancer
• tyrosine kinase inhibitors

References

1. World Cancer Report-2014. Geneva, Switzerland: World Health Organisation, International Agency for Research on Cancer, WHO Press, 2015
2. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics 2007. Cancer. J Clin 2007; 57: 43-66.42
3. Luzzatto L, Pandolfi PP. Causality and chance in the development of cancer. N Engl J Med. 2015;373(16):1579
4. Estig D, Ahlering TE, Lieskovsky G, et ai:Experience with fossarecurrance of renal cell carcinoma. J Urol, 147: 1491, 1992
5. Gelister JSK, Falzon M, Crawford R, Chapple CR, et al:Urinary tractmetastasis from renal carcinoma. Br J Urol 1992;69: 250,
6. Williams R.D:Renal, perirenal and ureteral neoplasms. In Adult and Pediatric J. Urology. Edited by J. Y. Gillenwater, J. T. Grayhack, S. S. Howards, J. W. Ducked. Chicago-London Boca Raton. Yearbook Medical Publishers inc:Vol. 1, chapt 16, pp: 1988;513-554,
7. Gold PJ, Fefer A, Thompson JA:Paraneoplastic manifestations ofrenal cell carcinoma. Semin Urol Oncol 1996; 14:216-222.
8. Bellocco, R., Pasquali, E., Rota, M., Bagnardi, V., Tramacere, I., Scotti, L.,et al. Alcohol drinking and risk of renal cell carcinoma: results of a meta-analysis. Annals of oncology, mds022. ;2002

9. McLaughlin JK, Linblad P, Mellemgaard A., et. al:International renal cell cancer study:I. Tobacco use. Int. J. Cancer 1995; 60:194-198.
10. Beck, S.D., Patel, M.I., Snyder, M.E., Kattan, M.W., Motzer, R.J., Reuter, V.E. ve diğerleri. Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carcinoma. Ann Surg Oncol, 2004;11 (1), 71-77.
11. Kidney Cancer, NCCN Guidelines Version 1.2013. (2013).
12. Atkins MB. Management of advanced renal cancer. Kidney Int 2005; 67:2069.
13. Powles T, Plimack ER, Soulières D, et al. Pembrolizumab plus axitinib versus sunitinib monotherapy as first-line treatment of advanced renal cell carcinoma (KEYNOTE-426): extended follow-up from a randomised, open-label, phase 3 trial. Lancet Oncol 2020; 21:1563.
14. Cella D, Motzer RJ, Suarez C, et al. Patient-reported outcomes with first-line nivolumab plus cabozantinib versus sunitinib in patients with advanced renal cell carcinoma treated in CheckMate 9ER: an open-label, randomised, phase 3 trial. Lancet Oncol 2022; 23:292.
15. Escudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol 2019; 30:706.
16. Albiges L, Tannir NM, Burotto M, et al. Nivolumab plus ipilimumab versus sunitinib for first-line treatment of advanced renal cell carcinoma: extended 4-year follow-up of the phase III CheckMate 214 trial. ESMO Open 2020; 5:e001079.
17. Regan MM, Jegede OA, Mantia CM, et al. Treatment-free Survival after Immune Checkpoint Inhibitor Therapy versus Targeted Therapy for Advanced Renal Cell Carcinoma: 42-Month Results of the CheckMate 214 Trial. Clin Cancer Res 2021; 27:6687.
18. Lipworth, L.,Tarone, R. E., McLaughlin, J. K. Theepidemiology of renalcellcar-cinoma. TheJournal of urology, 2006, 176.6: 2353-2358.
19. Patard JJ, Leray E, Rioux-Leclercq N, et al. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol 2005, 23 (12), 2763-2771.
20. Karakiewicz, P.I., Hutterer, G.C., Trinh, Q.D., Pantuck, A.J., Klatte, T., Lam, J.S. ve diğerleri. Unclassified renal cell carcinoma: an analysis of 85 cases. BJU Int, 2007; 100 (4), 802-808.)
21. Mathieu R, Pignot G, Ingles A, Crepel M, Bigot P, Bernhard JC, Joly F, Guy L, Ravaud A, Azzouzi AR, Gravis G, Chevreau C, Zini L, Lang H, Pfister C, Lechevallier E, Fais PO, Berger J, Vayleux B, Roupret M, Audenet F, Descazeaud A, Rigaud J, Machiels JP, Staehler M, Salomon L, Ferriere JM, Kleinclauss F, Bensalah K, Patard JJ. Nephrectomy improves overall survival in patients with metastatic renal cell carcinoma in cases of favorable MSKCC or ECOG prognostic features. Urol Oncol. 2015 Aug;33(8):339.e9-15. doi: 10.1016/j.urolonc.2015.05.014. Epub 2015 Jun 16. PMID: 26087971
22. Golimbu, M., Joshi, P., Sperber, A., Tessler, A., Al-Askari, S.,Morales, P. Renal cell carcinoma: survival and prognostic factors. Urology, 1986; 27 (4), 291-301.
23. Maldazys, J.D.,deKernion, J.B. Prognostic factors in metastatic renal carcinoma. J Urol, 1986; 136 (2), 376-379.
24. Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Rixe O, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med 2007;356(2):115–24.
25. Schnadig ID, Hutson TE, Chung H, Dhanda R, Halm M, Forsyth M, et al. Dosing patterns, toxicity, and outcomesin patients treated with first-line sunitinib foradvanced renal cell carcinoma in community-based practices. Clin Genitourin Cancer 2014;12(6):413–21.
26. Gore ME, Szczylik C, Porta C, Bracarda S, Bjarnason GA, Oudard S, et al. Safety and efficacy of sunitinib for metastatic renal-cell carcinoma: an expanded-access trial. Lancet Oncol 2009;10(8):757–63.
27. Schnadig ID, Hutson TE, Chung H, Dhanda R, Halm M, Forsyth M, et al. Dosing patterns, toxicity, and outcomes in patients treated with first-line sunitinib for advanced renal cell carcinoma in community-based practices. Clin Genitourin Cancer 2014;12(6):413–21
28. Domagala-Haduch M, Cedrych I, Jasiowka M, Niemiec M, Skotnicki P. Analysis of adverse events of sunitinib in patients treated for advanced renal cell carcinoma. Arch Med Sci. 2016;12(2).