1769 A PHASE I TRIAL OF VEGFR1 PEPTIDE VACCINES FOR PATIENTS WITH METASTATIC RENAL CELL CARCINOMA

Abstract

The commonest reason for not performing surgery was disease progression 13 (20%). The median PFS and OS for the cohort was 7 months (95% CI 6–11 months) and 15 months (95%CI: 10-NA). Fourteen (30%) patients had progression of disease during the treatment break for surgery, 9 of whom achieved further clincal benifit with further sunitinib. The OS for patients with intermediate and poor risk disease was 26 months (11-not reached(NR) months) and 8 months (4-NR months) respectively. The MSKCC poor risk patients fell into 2 groups, those with progressive metastasis who did not undergo surgery (55%) as opposed to a subgroup who obtained clinical benefit with therapy and went on to have CN (45%). These patients had an improved outcome compared to those with primary refractory disease (median OS 6 vs 12 months). Neither a reduction in the size of the primary tumour (above median: 14%) or increased necrosis at surgery ( 50%) correlated with outcome (HR 1.8 [0.89–4.06] and HR 1.68 HR 0.64– 4.39] respectively). CONCLUSIONS: The outcome of patients with MSKCC intermediate risk treated with sunitinib prior to CN is encouraging and consistent with results seen in the phase III trial sunitinib versus interferon in which most patients had initial nephrectomy, most of them with metachronous mRCC. The role of surgery in the poor risk population remains unclear. It may be useful in those who have clinical benefit with upfront sunitinib.