Abstract
Background
Although targeted therapies with inhibitors of the vascular endothelial growth factor
(VEGF) are the mainstay of treatment for metastatic renal cell carcinoma, there are
limited data on the outcome of patients with long-term response to this treatment.
Patients and Methods
In a retrospective, registry-based study, patients continuously treated with first-line
anti-VEGF agents for at least 24 months were included. In total, 219 patients had
evaluable data and were included in the outcome analysis.
Results
Median progression-free survival (PFS) after initiation of first-line targeted therapy
was 39.7 months (95% confidence interval [CI], 35.9-43.5 months), with 5-year PFS
of 34.2% (95% CI, 27.2%-41.2%). Median overall survival (OS) reached 79.1 months (95%
CI, 65.2-93.0 months) with the 5-year OS of 62.1% (95% CI, 54.5%-69.7%). In this cohort,
28, 103, and 88 patients achieved complete response (CR), partial response (PR), or
stable disease (SD) as the best response, respectively. Median PFS and OS were comparable
in patients with PR and SD, but significantly longer in patients with CR (log rank
test P value for PFS difference < .001 and .009 for OS difference).
Conclusion
There are marked differences in PFS and OS between patients who receive long-term
anti-VEGF treatment, achieving CR and non-CR as the best clinical response. Patients
with non-CR experienced a relatively high progression rate shortly after the landmark
time point of 2 years.
Keywords
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Article info
Publication history
Published online: June 29, 2017
Accepted:
June 25,
2017
Received in revised form:
January 14,
2017
Received:
November 19,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
