Third-line Therapy for Metastatic Renal Cell Carcinoma and Its Effect on Quality of Life and Overall Survival: A National, Multicenter, Observational Study
Received Date : 26 Mar 2020
Accepted Date : 23 Jun 2020
Available Online : 14 Jul 2020
İrfan ÇİÇİNa, Aydın ÇİLTAŞb, Saadettin KILIÇKAPc, Berna ÖKSÜZOĞLUd, Doğan UNCUe, Mehmet ARTAÇf, Havva YEŞİL ÇINKIRg, Abdurrahman IŞIKDOĞANh, Faysal DANEi, Mehmet ALİUSTAOĞLUj, Hacı Mehmet TÜRKk, Emin Tamer ELKIRANl, Erdem ÇUBUKÇUm, Meltem EKENELn, Feyyaz ÖZDEMİRo, Ali GÖKYERa, İlhan ÖZTOPp, Ahmet ALACACIOĞLUr, Hüseyin ÖZTÜRKs, Birkan AVERs, Metin ÖZKANt
aTrakya University Faculty of Medicine, Department of Internal Medicine, Division of Oncology, Edirne, TURKEY
bGazi University Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Ankara, TURKEY
cHacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Ankara, TURKEY
dDr. Abdurrahman Yurtarslan Ankara Oncology Training and Research Hospital, Department of Internal Medicine,
Division of Medical Oncology, Ankara, TURKEY
eUniversiy of Health Sciences Ankara Numune Training and Research Hospital, Clinic of Medical Oncology, Ankara, TURKEY
fNecmettin Erbakan University Meram Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Konya, TURKEY
gGaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Gaziantep, TURKEY
hDicle University Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Diyarbakır, TURKEY
iMarmara University Pendik Training and Research Hospital, Department of Internal Medicine, Division of Medical Oncology, İstanbul, TURKEY
jKartal Dr. Lütfi Kirdar Training and Research Hospital, Department of Medical Oncology, İstanbul, TURKEY
kBezmialem Vakıf University Faculty of Medicine, Department of Medical Oncology, İstanbul, TURKEY
lİnönü University Turgut Ozal Medical Center, Department of Internal Medicine, Division of Medical Oncology, Malatya, TURKEY
mAli Osman Sönmez Oncology Hospital, Department of Medical Oncology, Bursa, TURKEY
nIstanbul University Istanbul Medical Faculty, Department of Medical Oncology, İstanbul, TURKEY
oKaradeniz Technical University Faculty of Medicine, Department of Internal Medicine, Trabzon, TURKEY
pDokuz Eylül University Faculty of Medicine, Department of Medical Oncology, İzmir, TURKEY
rIzmir Katip Çelebi University Atatürk Training and Research Hospital, Department of Medical Oncology, İzmir, TURKEY
sPfizer Pharmaceuticals, Medical Oncology Department, İstanbul, TURKEY
tErciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, TURKEY
Doi: 10.37047/jos.2020-75080 - Article's Language: EN
J Oncol Sci.2020;6(2):87-95
ABSTRACT
Objective: The study aimed to evaluate the efficacy of targeted therapies used as the third-line treatment after first-line cytokine
and second-line tyrosine kinase inhibitor (TKI) therapies in metastatic renal cell carcinoma (mRCC) patients and assess the quality of life (QoL)
of patients. Material and Methods: This national, multicenter, non-interventional study included patients aged ≥18 years with histologically
confirmed mRCC, receiving targeted therapies as the third-line treatment for the last one month. Overall survival (OS), progression-free survival
(PFS), adverse events (AEs), and QoL were evaluated. Results: The study included 102 mRCC patients (74 males) (median age of 61
years). The median disease duration since diagnosis was 27.5 months (ranging 4-201 months). Of all the patients, 75.5% and 24.5% were receiving
Axitinib and Everolimus, respectively, as third-line therapy. In all patients, the one-year PFS and OS rates were 62.9% and 79.9%,
respectively. Seventy-one AEs (mostly mild) developed in 29 (28.4%) patients, fatigue being the most common (9.8%) AE. As compared to
the baseline, no significant change was observed in the QoL scores of patients in the 12th month. The Axitinib and Everolimus groups did not
differ significantly as regards to PFS and OS. Of the 11 patients with grade III-IV AEs, four were from the Everolimus group, and seven belonged
to the Axitinib group. The QoL scores did not show a significant difference between the two groups except for that in the 12th month.
Conclusion: Third-line therapy in mRCC patients was found to be effective and tolerable. Prolonged survival in mRCC patients receiving an
increasing number of therapy lines requires further evaluation of QoL, considering it to be a part of treatment assessment.
Keywords: Clear-cell metastatic renal cell carcinoma; quality of life; survival
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