PMID- 32693975
OWN - NLM
STAT- MEDLINE
DCOM- 20210805
LR  - 20210805
IS  - 1873-2496 (Electronic)
IS  - 1078-1439 (Linking)
VI  - 38
IP  - 12
DP  - 2020 Dec
TI  - Discontinuation of first-line molecular-targeted therapy and prognosis in 
      patients with metastatic renal cell carcinoma: Impact of disease progression vs. 
      adverse events.
PG  - 937.e19-937.e25
LID - S1078-1439(20)30293-3 [pii]
LID - 10.1016/j.urolonc.2020.06.023 [doi]
AB  - OBJECTIVES: We evaluated the impact of discontinuation of first-line (1L) 
      molecular-targeted therapy on prognostic outcomes among patients with metastatic 
      renal cell carcinoma (mRCC). METHODS: Study patients with mRCC were treated with 
      1L molecular-targeted agents at 4 separate institutions. Prognostic outcomes in 
      this patient cohort were analyzed retrospectively based on whether 
      discontinuation of 1L therapy was related to adverse events (AEs) or progression 
      of disease (PD). RESULTS: Of the 201 patients enrolled, 117 patients (58%) and 84 
      patients (42%) discontinued 1L targeted therapy due to PD and AEs, respectively. 
      Second-line therapy was subsequently provided to 101 (86%) and 66 (79%) of the 
      patients who discontinued 1L therapy secondary to PD or AEs, respectively. 
      Patients who discontinued 1L therapy due to AEs were significantly older than 
      those with PD. The progression-free survival and overall survival from the 
      initiation of 1L targeted therapy were significantly longer in patients who 
      discontinued 1L therapy due to AE than in those who discontinued 1L therapy due 
      to PD. The OS from the initiation of second-line targeted therapy was 
      significantly longer in patients who discontinued 1L therapy due to AE than those 
      with PD. Furthermore, AE as a reason for discontinuation of 1L targeted therapy 
      as opposed to PD was independently associated with longer progression-free 
      survival and OS as determined by multivariate analysis. CONCLUSIONS: Our findings 
      suggest that mRCC patients who discontinue 1L therapy due to AEs have a more 
      favorable prognosis than those who discontinue therapy due to PD.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Ando, Ryosuke
AU  - Ando R
AD  - Department of Nephro-urology, Nagoya City University Graduate School of Medical 
      Sciences, Nagoya, Japan. Electronic address: ryo@med.nagoya-cu.ac.jp.
FAU - Takahara, Kiyoshi
AU  - Takahara K
AD  - Department of Urology, Fujita Health University School of Medicine, Toyoake, 
      Aichi, Japan.
FAU - Ito, Toshiki
AU  - Ito T
AD  - Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, 
      Shizuoka, Japan.
FAU - Kanao, Kent
AU  - Kanao K
AD  - Department of Urology, Aichi Medical University School of Medicine, Nagakute, 
      Aichi, Japan; Department of Uro-Oncology, Saitama Medical University 
      International Medical Center, Hidaka, Saitama, Japan.
FAU - Kobayashi, Ikuo
AU  - Kobayashi I
AD  - Department of Urology, Aichi Medical University School of Medicine, Nagakute, 
      Aichi, Japan.
FAU - Shiroki, Ryoichi
AU  - Shiroki R
AD  - Department of Urology, Fujita Health University School of Medicine, Toyoake, 
      Aichi, Japan.
FAU - Sumitomo, Makoto
AU  - Sumitomo M
AD  - Department of Urology, Fujita Health University School of Medicine, Toyoake, 
      Aichi, Japan.
FAU - Miyake, Hideaki
AU  - Miyake H
AD  - Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, 
      Shizuoka, Japan.
FAU - Yasui, Takahiro
AU  - Yasui T
AD  - Department of Nephro-urology, Nagoya City University Graduate School of Medical 
      Sciences, Nagoya, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200718
PL  - United States
TA  - Urol Oncol
JT  - Urologic oncology
JID - 9805460
SB  - IM
MH  - Aged
MH  - Carcinoma, Renal Cell/*drug therapy/secondary
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Kidney Neoplasms/*drug therapy/pathology
MH  - Male
MH  - Middle Aged
MH  - Molecular Targeted Therapy/*adverse effects
MH  - Prognosis
MH  - Retrospective Studies
MH  - *Withholding Treatment
OTO - NOTNLM
OT  - Discontinuation therapy
OT  - Metastatic renal cell carcinoma
OT  - Molecular-targeted therapy
COIS- Conflicts of interest The authors have no conflicts of interest to declare.
EDAT- 2020/07/23 06:00
MHDA- 2021/08/06 06:00
CRDT- 2020/07/23 06:00
PHST- 2020/03/31 00:00 [received]
PHST- 2020/06/03 00:00 [revised]
PHST- 2020/06/20 00:00 [accepted]
PHST- 2020/07/23 06:00 [pubmed]
PHST- 2021/08/06 06:00 [medline]
PHST- 2020/07/23 06:00 [entrez]
AID - S1078-1439(20)30293-3 [pii]
AID - 10.1016/j.urolonc.2020.06.023 [doi]
PST - ppublish
SO  - Urol Oncol. 2020 Dec;38(12):937.e19-937.e25. doi: 10.1016/j.urolonc.2020.06.023. 
      Epub 2020 Jul 18.