Department of Medicine I, Clinical Division of Oncology and Cancer Center, Medical University Vienna, Vienna, Austria.
BMC Cancer. 2010 Sep 7;10:480. doi: 10.1186/1471-2407-10-480.
In the era of cytokines, patients with brain metastases (BM) from renal cell carcinoma had a significantly shorter survival than patients without. Targeted agents (TA) have improved the outcome of patients with metastatic renal cell carcinoma (mRCC) however, their impact on patients with BM is less clear. The aim of this analysis was to compare the outcome of patients with and without BM in the era of targeted agents.
Data from 114 consecutive patients who had access to targeted agent were analyzed for response rates (ORR), progression free survival (PFS) and overall survival (OS). All patients diagnosed with BM underwent local, BM-specific treatment before initiation of medical treatment.
Data of 114 consecutive patients who had access to at least one type of targeted agents were analyzed. Twelve out of 114 renal cell carcinoma (RCC) patients (10.5%) were diagnosed with BM. Systemic treatment consisted of sunitinib, sorafenib, temsirolimus or bevacizumab. The median PFS was 8.7 months (95% CI 5.1 - 12.3) and 11.4 months (95% CI 8.7 - 14.1) for BM-patients and non-BM-patients, respectively (p = 0.232). The median overall survival for patients with and without BM was 13.4 (95% CI 1- 43.9) and 33.3 months (95% CI 18.6 - 47.0) (p = 0.358), respectively. No patient died from cerebral disease progression. ECOG Performance status and the time from primary tumor to metastases (TDM) were independent risk factors for short survival (HR 2.74, p = 0.001; HR: 0.552, p = 0.034).
Although extracerebral metastases determine the outcome of patients with BM, the benefit from targeted agents still appears to be limited when compared to patients without BM.
在细胞因子时代，患有脑转移（BM）的肾细胞癌（RCC）患者的生存期明显短于无 BM 的患者。靶向药物（TA）改善了转移性肾细胞癌（mRCC）患者的预后，然而，它们对 BM 患者的影响尚不清楚。本分析的目的是比较靶向药物时代有和无 BM 患者的结局。
对接受靶向药物治疗的 114 例连续患者的数据进行分析，以评估客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）。所有诊断为 BM 的患者在开始药物治疗前均接受局部、BM 特异性治疗。
对接受至少一种类型的靶向药物治疗的 114 例连续患者的数据进行了分析。114 例 RCC 患者中有 12 例（10.5%）被诊断为 BM。全身治疗包括舒尼替尼、索拉非尼、替西罗莫司或贝伐珠单抗。BM 患者和非 BM 患者的中位 PFS 分别为 8.7 个月（95%CI5.1-12.3）和 11.4 个月（95%CI8.7-14.1）（p=0.232）。有和无 BM 的患者的中位总生存期分别为 13.4 个月（95%CI1-43.9）和 33.3 个月（95%CI18.6-47.0）（p=0.358）。无患者死于脑转移进展。ECOG 表现状态和从原发肿瘤到转移的时间（TDM）是影响生存期的独立危险因素（HR2.74，p=0.001；HR：0.552，p=0.034）。
尽管脑外转移决定了 BM 患者的结局，但与无 BM 的患者相比，靶向药物的获益似乎仍然有限。
