Clinical Division of Oncology and Cancer Centre, Department of Medicine I, Medical University of Vienna, Austria.
Acta Oncol. 2012 Jan;51(1):101-6. doi: 10.3109/0284186X.2011.589404. Epub 2011 Jul 8.
First line treatment with temsirolimus is considered standard of care in poor risk patients with metastatic renal cell carcinoma. The role of temsirolimus in pretreated patients with any risk profile is unclear. The aim of this retrospective analysis was to investigate the impact of temsirolimus in patients who had progressed on various treatment lines.
From April 2007 to July 2009, all patients who had progressed on receptor-tyrosine kinase-inhibitors, VEGF-antibodies and other agents were treated with temsirolimus (25 mg weekly). Physical examination, white blood cell count and chemistry were obtained weekly and tumor response was assessed every 12 weeks.
Thirty patients with a median age of 68 years range (44-81) received treatment with temsirolimus. Most patients were categorized intermediate risk (60%) and the majority had three or more metastatic sites (56.7%). Temsirolimus was median the fourth (range 2-5) systemic treatment line. Grade 3 and 4 toxicities were rare and consisted of anemia, thrombocytopenia and hyperglycemia. Objective remission and stable disease were achieved in 13.3% and 60% of the patients, respectively. The median progression free survival was 4.9 months (2.93-6.81 95% CI).
Temsirolimus appears feasible, safe and active in heavily pretreated patients.
替西罗莫司一线治疗被认为是转移性肾细胞癌高危患者的标准治疗方法。替西罗莫司在任何风险特征的预处理患者中的作用尚不清楚。本回顾性分析的目的是研究替西罗莫司在各种治疗线进展后的患者中的影响。
从 2007 年 4 月至 2009 年 7 月，所有接受受体酪氨酸激酶抑制剂、VEGF 抗体和其他药物治疗后进展的患者均接受替西罗莫司（每周 25mg）治疗。每周进行体格检查、白细胞计数和化学检查，并每 12 周评估肿瘤反应。
30 名中位年龄为 68 岁（范围为 44-81）的患者接受了替西罗莫司治疗。大多数患者被归类为中危（60%），大多数患者有三个或更多转移部位（56.7%）。替西罗莫司是中位数第四（范围 2-5）线系统治疗。3 级和 4 级毒性罕见，包括贫血、血小板减少和高血糖。客观缓解和疾病稳定的患者分别为 13.3%和 60%。中位无进展生存期为 4.9 个月（95%CI 为 2.93-6.81）。
替西罗莫司在预处理患者中似乎可行、安全且有效。
