Shetty Aditya V, Matrana Marc R, Atkinson Bradley J, Flaherty Amber L, Jonasch Eric, Tannir Nizar M
Internal Medicine Residency Program, University of Texas Medical School at Houston, Houston, TX.
Department of Hematology and Oncology, Ochsner Medical Center, New Orleans, LA.
Clin Genitourin Cancer. 2014 Oct;12(5):348-53. doi: 10.1016/j.clgc.2014.01.004. Epub 2014 Jan 18.
Limited data are available regarding patients with renal cell carcinoma and ESRD treated with TTs. The objective of this study was to explore the tolerability and safety of TT in patients with mRCC and ESRD.
We retrospectively identified patients with mRCC and ESRD treated at the University of Texas M.D. Anderson Cancer Center from 2002 to 2012. Patient characteristics including demographic, histology, treatment, and adverse events are reported. Duration of treatment (TOT) was determined from date of drug initiation to discontinuation. Overall survival (OS) was determined from initiation of TT to death. Statistics are descriptive.
Fourteen patients were identified. Ten patients had clear-cell histology and 4 had papillary histology. The median number of TTs per patient was 3 (range, 1-4) with median TOT of 28 months for all TTs. Eighty-eight percent of all toxicities were Grade 1 to 2; no Grade 4 toxicities were noted. Treatment discontinuations included 3 patients treated with sorafenib due to hand-foot syndrome, intolerable fatigue, and squamous cell skin cancer development; 2 patients treated with pazopanib due to intolerable fatigue and increased transaminase levels; and 1 patient treated with everolimus due to pneumonitis. Eight patients died from progressive disease. Median OS from initiation of TT was 28.5 months and 35 months from time of diagnosis.
Toxicities were mild to moderate and consistent with those reported in previous studies. TTs appear to be safe, well tolerated and produce antitumor response in patients with mRCC and ESRD receiving dialysis.
关于接受酪氨酸激酶抑制剂（TTs）治疗的肾细胞癌和终末期肾病（ESRD）患者的数据有限。本研究的目的是探讨TTs在转移性肾细胞癌（mRCC）和ESRD患者中的耐受性和安全性。
我们回顾性确定了2002年至2012年在德克萨斯大学MD安德森癌症中心接受治疗的mRCC和ESRD患者。报告了患者的特征，包括人口统计学、组织学、治疗情况和不良事件。治疗持续时间（TOT）从药物开始使用日期至停药日期确定。总生存期（OS）从开始使用TTs至死亡确定。统计数据为描述性的。
共确定了14例患者。10例患者为透明细胞组织学类型，4例为乳头状组织学类型。每位患者接受TTs的中位数为3次（范围为1 - 4次），所有TTs的中位TOT为28个月。所有毒性反应的88%为1至2级；未观察到4级毒性反应。治疗中断情况包括：3例接受索拉非尼治疗的患者因手足综合征、无法耐受的疲劳和鳞状细胞皮肤癌进展而停药；2例接受帕唑帕尼治疗的患者因无法耐受的疲劳和转氨酶水平升高而停药；1例接受依维莫司治疗的患者因肺炎停药。8例患者死于疾病进展。从开始使用TTs起的中位OS为28.5个月，从诊断时起为35个月。
毒性反应为轻至中度，与先前研究报告的一致。TTs在接受透析的mRCC和ESRD患者中似乎是安全的，耐受性良好，并能产生抗肿瘤反应。
