Targeted Therapy in Metastatic Renal Cell Carcinoma

Abstract

Purpose: To evaluate the efficacy and safety of targeted therapy in patients with metastatic renal cell carcinoma. Materials and Methods: In this retrospective analysis, 43 consecutive patients with metastatic renal cell carcinoma received targeted therapy between December 2005 and December 2007. All patients underwent radical nephrectomy. Twenty-two patients received targeted therapy as a first-line treatment and 21 as a second-line treatment. Results: The median follow-up duration after radical nephrectomy and after the initiation of targeted therapy was 87 and 14 months, respectively. The initial response rate was 74.4% (partial response 37.2%, stable disease 37.2%) and the last response rate was 34.9% (partial response 4.7%, stable disease 30.2%). The median survival was 17 months (95% confidence interval (CI), 11.6-22.4) and the median progression-free survival was 10 months (95% CI, 7.5-12.5). Eleven patients (50%) with synchronous metastasis and 3 (14.3%) with metachronous metastasis died from renal cell carcinoma (p=0.023), but there was no significant difference in terms of median survival (15 months vs. longer than 14 months, p=0.210). Also, there was a significant difference in the overall mortality of the MSKCC risk groups (13.3% vs. 44.4%, p=0.049), but no significant difference in median survival (longer than 14 months vs. 15 months, p=0.236). Conclusions: Targeted therapy shows promising clinical activity in patients with metastatic renal cell carcinoma. Time to metastasis and MSKCC risk group may be associated with overall survival, and the prognostic implications of those factors should be analyzed in further prospective studies. (Korean J Urol 2009;50:1-5)