Latteux G, Lebdai S, Hoarau N, Abadie-Lacourtoisie S, Delva R, Chautard D, Azzouzi A-R, Bigot P
Service d'urologie, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
Prog Urol. 2013 Mar;23(3):184-94. doi: 10.1016/j.purol.2012.09.014. Epub 2012 Oct 25.
To evaluate the outcomes following targeted therapies in the management of metastatic renal cell carcinoma (mRCC), through the study of overall survival (OS) and progression-free (PFS).
We retrospectively included 78 patients treated with targeted therapies for mRCC at the Paul Papin Cancer Institute from 2004 to 2009. Overall survival (OS), progression free survival (PFS), response to treatment, occurrence of grade III and IV side effects, were analyzed following first and second line treatments.
Median follow-up was 33 months [5-236], and 41 patients died (52.6%). Median OS was 36 months [95% CI 29-43]. The median PFS was 14 months [95% CI 6.71-21.29] for sunitinib, 38 months [95% CI 11.41-64.59] for bevacizumab with interferon (IFN), and 8 months [95% CI 0-17.03] for IFN alone. A partial reduction, stabilization or increase in tumor size was observed for 19.2%, 47.4% and 25.6% of cases. A second line treatment was given for 53 patients. They received either sunitinib (n=20, 37.8%), bevacizumab with IFN (n=7, 13.2%), sorafenib (n=17, 32.2%), temsirolimus (n=3, 5.6%) or other molecules (n=6 11.2%). Grade III or IV side effects were observed for 14.1%, 28.3% and 18.2% of the patients following first, second and third line treatment, respectively.
Outcomes of targeted therapies in our center upheld the literature data. These therapies allow a benefit survival versus immunotherapy, with sometimes large side-effect.
通过研究总生存期（OS）和无进展生存期（PFS），评估靶向治疗在转移性肾细胞癌（mRCC）管理中的疗效。
我们回顾性纳入了2004年至2009年在保罗·帕潘癌症研究所接受靶向治疗的78例mRCC患者。分析一线和二线治疗后的总生存期（OS）、无进展生存期（PFS）、治疗反应、III级和IV级副作用的发生情况。
中位随访时间为33个月[5 - 236]，41例患者死亡（52.6%）。中位OS为36个月[95%置信区间29 - 43]。舒尼替尼的中位PFS为14个月[95%置信区间6.71 - 21.29]，贝伐单抗联合干扰素（IFN）为38个月[95%置信区间11.41 - 64.59]，单独使用IFN为8个月[95%置信区间0 - 17.03]。观察到19.2%、47.4%和25.6%的病例肿瘤大小有部分缩小、稳定或增大。53例患者接受了二线治疗。他们接受了舒尼替尼（n = 20，37.8%）、贝伐单抗联合IFN（n = 7，13.2%）、索拉非尼（n = 17，32.2%）、替西罗莫司（n = 3，5.6%）或其他分子（n = 6，11.2%）。分别有14.1%、28.3%和18.2%的患者在一线、二线和三线治疗后出现III级或IV级副作用。
我们中心靶向治疗的疗效与文献数据一致。这些治疗与免疫治疗相比可使生存期获益，但有时副作用较大。
