PMID- 22460837
OWN - NLM
STAT- MEDLINE
DCOM- 20130719
LR  - 20211203
IS  - 1559-131X (Electronic)
IS  - 1357-0560 (Linking)
VI  - 29
IP  - 5
DP  - 2012 Dec
TI  - Comparative efficacy of vascular endothelial growth factor (VEGF) tyrosine kinase 
      inhibitor (TKI) and mammalian target of rapamycin (mTOR) inhibitor as second-line 
      therapy in patients with metastatic renal cell carcinoma after the failure of 
      first-line VEGF TKI.
PG  - 3291-7
LID - 10.1007/s12032-012-0227-7 [doi]
AB  - Sequential therapy is a standard strategy used to overcome the limitations of 
      targeted agents in metastatic renal cell carcinoma. It remains unclear whether a 
      mammalian target of rapamycin (mTOR) inhibitor is a more effective second-line 
      therapy after first-line vascular endothelial growth factor tyrosine kinase 
      inhibitor (VEGF TKI) has failed than the alternative, VEGF TKI. A clinical 
      database was used to identify all patients with renal cell carcinoma who failed 
      at first-line VEGF TKI and then treated with second-line VEGF TKI or mTOR 
      inhibitors in the Asan Medical Center. Patient medical characteristics, 
      radiological response and survival status were assessed. Of the 83 patients who 
      met the inclusion criteria, 41 received second-line VEGF TKI [sunitinib (n = 16) 
      and sorafenib (n = 25)] and 42 were treated with mTOR inhibitors [temsirolimus (n 
      = 11) and everolimus (n = 31)]. After a median follow-up duration of 23.9 months 
      (95 % CI, 17.8-30.0), progression-free survival was 3.0 months for both groups 
      [hazard ratio (HR, VEGF TKI vs. mTOR inhibitor) = 0.97, 95 % CI 0.59-1.62, P = 
      0.92]. Overall survival was 10.6 months for the VEGF TKI group and 8.2 months for 
      the mTOR inhibitor group (HR = 0.98, 95 % CI 0.57-1.68, P = 0.94). The two groups 
      did not differ significantly in terms of disease control rate (51 % for VEGF TKI 
      and 59 % for mTOR inhibitor, P = 0.75). Second-line VEGF TKI seems to be as 
      effective as mTOR inhibitors and may be a viable option as a second-line agent 
      after first-line anti-VEGF agents have failed.
FAU - Park, Kwonoh
AU  - Park K
AD  - Department of Oncology, Asan Medical Center, University of Ulsan College of 
      Medicine, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul, 138-736, Korea.
FAU - Lee, Jae-Lyun
AU  - Lee JL
FAU - Park, Inkeun
AU  - Park I
FAU - Park, Seongjoon
AU  - Park S
FAU - Ahn, Yongcheol
AU  - Ahn Y
FAU - Ahn, Jin-Hee
AU  - Ahn JH
FAU - Ahn, Shin
AU  - Ahn S
FAU - Song, Cheryn
AU  - Song C
FAU - Hong, Jun Hyuk
AU  - Hong JH
FAU - Kim, Choung-Soo
AU  - Kim CS
FAU - Ahn, Hanjong
AU  - Ahn H
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120330
PL  - United States
TA  - Med Oncol
JT  - Medical oncology (Northwood, London, England)
JID - 9435512
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Enzyme Inhibitors)
RN  - 0 (Indoles)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Pyrroles)
RN  - 25X51I8RD4 (Niacinamide)
RN  - 624KN6GM2T (temsirolimus)
RN  - 9HW64Q8G6G (Everolimus)
RN  - 9ZOQ3TZI87 (Sorafenib)
RN  - EC 2.7.10.1 (EGFR protein, human)
RN  - EC 2.7.10.1 (ErbB Receptors)
RN  - EC 2.7.10.1 (Protein-Tyrosine Kinases)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - V99T50803M (Sunitinib)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/*administration & dosage
MH  - Carcinoma, Renal Cell/*drug therapy/mortality
MH  - Enzyme Inhibitors/administration & dosage
MH  - ErbB Receptors/antagonists & inhibitors
MH  - Everolimus
MH  - Female
MH  - Humans
MH  - Indoles/administration & dosage
MH  - Kaplan-Meier Estimate
MH  - Kidney Neoplasms/*drug therapy/mortality
MH  - Male
MH  - Middle Aged
MH  - Niacinamide/administration & dosage/analogs & derivatives
MH  - Phenylurea Compounds/administration & dosage
MH  - Proportional Hazards Models
MH  - Protein-Tyrosine Kinases/antagonists & inhibitors
MH  - Pyrroles/administration & dosage
MH  - Salvage Therapy/*methods
MH  - Sirolimus/administration & dosage/analogs & derivatives
MH  - Sorafenib
MH  - Sunitinib
MH  - TOR Serine-Threonine Kinases/antagonists & inhibitors
MH  - Treatment Outcome
EDAT- 2012/03/31 06:00
MHDA- 2013/07/20 06:00
CRDT- 2012/03/31 06:00
PHST- 2012/02/29 00:00 [received]
PHST- 2012/03/20 00:00 [accepted]
PHST- 2012/03/31 06:00 [entrez]
PHST- 2012/03/31 06:00 [pubmed]
PHST- 2013/07/20 06:00 [medline]
AID - 10.1007/s12032-012-0227-7 [doi]
PST - ppublish
SO  - Med Oncol. 2012 Dec;29(5):3291-7. doi: 10.1007/s12032-012-0227-7. Epub 2012 Mar 
      30.