Haaker Lorenz, De Meue Elisabeth, Wildiers Hans, Verbiest Annelies, Dumez Herlinde, Lerut Evelyne, Pans Steven, Albersen Maarten, Beuselinck Benoit
Department of General Medical Oncology, University Hospitals Leuven, KULeuven , Leuven , Belgium.
Department of Pathology, University Hospitals Leuven, KULeuven , Leuven , Belgium.
Acta Clin Belg. 2019 Dec;74(6):414-423. doi: 10.1080/17843286.2018.1551744. Epub 2018 Nov 29.
: Metastatic clear-cell renal cell carcinoma (m-ccRCC) patients with bone metastases (BM) treated with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI) have a poorer outcome compared to patients without BM. We aimed to investigate whether an increased incidence of VEGFR-TKI treatment interruptions and/or dose reductions in patients with BM could explain this difference in outcome. : Retrospective study on m-ccRCC patients treated in first-line with VEGFR-TKI. Analysis of the incidence of treatment interruptions and dose reductions and time-to-event analysis. Study of the correlation with the presence of BM at start of first-line VEGFR-TKIs. : Two-hundred-and-five patients were included. In patients with BM, median time-to-dose-reduction was significantly shorter (3 versus 5 cycles; = 0.005) than in patients without BM. 63% of the total number of cycles was administered at reduced dose, compared to 41% in patients without BM. Age at start of VEGFR-TKI (≤ versus >70 years) was significantly associated with median time-to-dose-reduction (5 versus 3 cycles; = 0.007). On multivariate analysis, the presence of BM ( = 0.004; HR 1.82, 95%CI 1.21-2.73) and age at start of VEGFR-TKIs ( = 0.017; HR 1.65, 95%CI 1.10-2.50) were independently associated with time-to-dose-reduction. : In m-ccRCC patients treated with VEGFR-TKIs, dose reductions occurred earlier in patients with BM compared to patients without BM and in elderly patients.
与无骨转移（BM）的患者相比，接受血管内皮生长因子受体（VEGFR）酪氨酸激酶抑制剂（TKI）治疗的转移性透明细胞肾细胞癌（m-ccRCC）骨转移患者的预后较差。我们旨在研究BM患者中VEGFR-TKI治疗中断和/或剂量减少发生率的增加是否可以解释这种预后差异。：对一线接受VEGFR-TKI治疗的m-ccRCC患者进行回顾性研究。分析治疗中断和剂量减少的发生率以及事件发生时间分析。研究与一线VEGFR-TKIs开始时BM存在的相关性。：纳入205例患者。BM患者的中位剂量减少时间明显短于无BM患者（3个周期对5个周期；P = 0.005）。总周期数的63%是在减量情况下给药的，而无BM患者为41%。VEGFR-TKI开始时的年龄（≤70岁对>70岁）与中位剂量减少时间显著相关（5个周期对3个周期；P = 0.007）。多因素分析显示，BM的存在（P = 0.004；HR 1.82，95%CI 1.21-2.73）和VEGFR-TKIs开始时的年龄（P = 0.017；HR 1.65，95%CI 1.10-2.50）与剂量减少时间独立相关。：在接受VEGFR-TKIs治疗的m-ccRCC患者中，BM患者与无BM患者以及老年患者相比，剂量减少发生得更早。
