TKI therapy contributes to improved survival in RCC
medwireNews: Researchers have found an improvement in overall survival (OS) among a Swedish population of patients diagnosed with metastatic renal cell carcinoma (mRCC) that they attribute to increased nephrectomy rates and tyrosine kinase inhibitor (TKI) treatment.
Their study results showed an improvement in OS in patients diagnosed with RCC or mRCC between 2006 and 2008, after the introduction of TKIs in the European Union in 2006, compared with before.
"We also showed that TKI treatment together with an increased nephrectomy rate were two important factors behind the variation in observed OS in the mRCC cohorts," note Thomas Wahlgren (Pfizer AB, Sollentuna, Sweden) and colleagues.
"This was demonstrated by an almost 10-month survival benefit among TKI-treated patients compared with patients who received non-TKI or no therapy."
The researchers used data from three merged national health registers to analyze OS and the effects of cytokine (interferon-α, or the TKIs sunitinib or sorafenib) treatment on OS from 2000 to 2008.
During this period, 8009 patients were diagnosed with RCC, and 2753 (44%) with mRCC. The 5-year OS rates were 49% and 13%, respectively.
The estimated unadjusted median OS for the two groups was 60.5 months for RCC patients and 10.9 months for mRCC patients.
The researchers report in the British Journal of Cancer that there was a significant improvement in median OS over time. RCC patients diagnosed between 2006 and 2008 generally survived beyond 60.5 months, whereas those diagnosed between 2000 and 2005 had a median OS of 47.9 months. Similarly, the corresponding durations for those with mRCC were 12.4 months versus 9.6 months.
The factors significantly associated with improved OS in RCC patients were female versus male gender, lower versus younger age, and previous nephrectomy. For mRCC patients, they were female gender, previous nephrectomy, and any TKI prescription. Taking a TKI reduced the risk for death in mRCC patients by 38%, the researchers report.
They also note that "nearly all of the three treatments analysed, alone or used in sequences, were associated with improved OS compared with other or no treatment."
The only exception was sorafenib when used as a first-line treatment. The researchers were unable to confirm whether this finding implies inferior efficacy compared with other TKIs. By contrast, they say that their findings "related to sunitinib treatment appear to justify its recommendation as first-line treatment for mRCC in both European and US guidelines."
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
By Lucy Piper, Senior medwireNews Reporter