Medical Oncology Unit, Theagenion Cancer Hospital, Al. Simeonidi street 2, 54007 Thessaloniki, Greece.
Med Oncol. 2012 Jun;29(2):750-4. doi: 10.1007/s12032-010-9815-6. Epub 2011 Jan 30.
Sorafenib and sunitinib are inhibitors of receptor protein tyrosine kinases (TKIs) and are approved for the treatment of metastatic renal cell carcinoma (mRCC). Although the mTOR inhibitor everolimus is effective for the treatment of patients who have failed TKI therapy, it is important to consider all available treatment options before switching therapy mode of action. Herein, we report outcomes in patients with mRCC switched to sorafenib following disease progression on sunitinib treatment. The medical records of 35 patients treated between November 2006 and November 2009 at two large referral centers in Greece were retrospectively analyzed for time-to-progression (TTP), overall survival (OS), and tolerability of sorafenib after sunitinib. Median TTP and OS on sorafenib were 4.9 and 11.5 months, respectively. Among 33 patients evaluable for tumor response, three had a partial response and 17 achieved disease stabilization (objective response rate 8.5%; total clinical benefit rate 57%). Sorafenib was well tolerated, with mostly grade 1/2 adverse events and no treatment-related deaths. Sorafenib was effective and well tolerated in this group of patients. The TTP with sorafenib following sunitinib was comparable to outcomes reported previously, providing further support that TKIs should be used in sequence before switching to an mTOR inhibitor.
索拉非尼和舒尼替尼是受体蛋白酪氨酸激酶（TKIs）抑制剂，被批准用于治疗转移性肾细胞癌（mRCC）。虽然 mTOR 抑制剂依维莫司对 TKI 治疗失败的患者有效，但在转换治疗模式之前，考虑所有可用的治疗选择很重要。在此，我们报告了在索拉非尼治疗后，mRCC 患者在舒尼替尼治疗进展后改用索拉非尼的结果。对希腊两个大型转诊中心在 2006 年 11 月至 2009 年 11 月间治疗的 35 名患者的病历进行了回顾性分析，以评估索拉非尼的无进展生存期（TTP）、总生存期（OS）和舒尼替尼后对索拉非尼的耐受性。索拉非尼的中位 TTP 和 OS 分别为 4.9 和 11.5 个月。在 33 名可评估肿瘤反应的患者中，3 名患者有部分反应，17 名患者疾病稳定（客观缓解率 8.5%；总临床获益率 57%）。索拉非尼耐受性良好，主要为 1/2 级不良事件，无治疗相关死亡。在该组患者中，索拉非尼是有效且耐受良好的。索拉非尼继舒尼替尼之后的 TTP 与之前报道的结果相当，进一步支持在转换为 mTOR 抑制剂之前，应按顺序使用 TKI。
