Ren Zongtao, Niu Yunfeng, Fan Bo, Wei Shufei, Ma Yongliang, Zhang Xiaoyu, Guo Xiaoqiang, Zhang Aili
Department of Urology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Laboratory of Pathology, Hebei Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Ann Palliat Med. 2021 Jan;10(1):584-589. doi: 10.21037/apm-20-2465. Epub 2021 Jan 18.
Renal cell carcinoma (RCC) is the most common type of kidney cancer, and accounts for approximately 3% of all malignancies. Metastatic RCC (mRCC) is not sensitive to traditional radiotherapy and chemotherapy, therefore targeted therapy has become an important treatment option. In this study, the second-line targeted drug everolimus (Afinitor), a mammalian target of rapamycin (mTOR) inhibitor, was investigated for its clinical efficacy and adverse events in mRCC after failure of first-line targeted therapy, such as sorafenib, sunitinib or pazopanib.
A total of 21 patients with mRCC who had been treated with surgery or other therapies such as tyrosine kinase inhibitors (TKIs) were given oral everolimus (10 mg/day) until disease progression. Clinical efficacy was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) 2 months after therapy, including complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). The adverse events were observed, and timely treatment was provided.
Everolimus extended progression-free survival (PFS) in mRCC patients from 4 to 8 months (median 6.3 months). There were 3 patients with PR, 12 with SD, and 6 with PD, and the disease control rate (DCR) was 15/21 (71.4%). Common adverse events included stomatitis, rash, and pneumonitis.
This study provides further support that everolimus is still an important option in mRCC treatment after failure of first-line targeted therapy. However, clinical studies are still needed to further improve its therapeutic efficacy.
肾细胞癌(RCC)是最常见的肾癌类型,约占所有恶性肿瘤的3%。转移性肾细胞癌(mRCC)对传统放疗和化疗不敏感,因此靶向治疗已成为重要的治疗选择。在本研究中,对二线靶向药物依维莫司(飞尼妥),一种哺乳动物雷帕霉素靶蛋白(mTOR)抑制剂,在一线靶向治疗(如索拉非尼、舒尼替尼或帕唑帕尼)失败后的mRCC患者中的临床疗效和不良事件进行了研究。
共有21例接受过手术或酪氨酸激酶抑制剂(TKIs)等其他治疗的mRCC患者口服依维莫司(10mg/天),直至疾病进展。治疗2个月后,采用实体瘤疗效评价标准(RECIST)评估临床疗效,包括完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)和疾病进展(PD)。观察不良事件并及时给予治疗。
依维莫司将mRCC患者的无进展生存期(PFS)从4个月延长至8个月(中位6.3个月)。有3例患者达到PR,12例为SD,6例为PD,疾病控制率(DCR)为15/21(71.4%)。常见的不良事件包括口腔炎、皮疹和肺炎。
本研究进一步支持依维莫司在一线靶向治疗失败后的mRCC治疗中仍是重要选择。然而,仍需要临床研究进一步提高其治疗效果。