Progression free survival of first line vascular endothelial growth factor-targeted therapy is an important prognostic parameter in patients with metastatic renal cell carcinoma

2012 ◽  
Vol 48 (7) ◽  
pp. 1023-1030 ◽  
Author(s):  
Christoph Seidel ◽  
Jonas Busch ◽  
Steffen Weikert ◽  
Sandra Steffens ◽  
Martin Fenner ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Vascular Endothelial Growth Factor ◽  
Targeted Therapy ◽  
Growth Factor ◽  
Renal Cell ◽  
Progression Free Survival ◽  
Vascular Endothelial ◽  
First Line ◽  
Free Survival ◽  
Endothelial Growth Factor

scholarly journals Treatment options in advanced renal cell carcinoma after first-line treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors

2016 ◽  
Vol 10 (11-12) ◽  
pp. 242 ◽  
Author(s):  
Naveen S. Basappa
Keyword(s):  
Renal Cell Carcinoma ◽  
Vascular Endothelial Growth Factor ◽  
Targeted Therapy ◽  
Growth Factor ◽  
Renal Cell ◽  
Vascular Endothelial ◽  
Second Line ◽  
First Line ◽  
Line Setting ◽  
Endothelial Growth Factor

Targeted therapy for metastatic renal cell carcinoma (mRCC) was introduced a decade ago, and since then a number of therapeutic options have been developed. Vascular endothelial growth factor targeted therapy is the widely accepted first-line option for mRCC. After progression, treatment in the second-line setting has typically been with either axitinib or everolimus. However, with the advent of several new agents demonstrating efficacy in the second-line setting, including nivolumab, cabozantinib, and the combination of lenvatinib and everolimus, the treatment paradigm has shifted toward these novel therapies with improved patient outcomes.

scholarly journals BEST: A Randomized Phase II Study of Vascular Endothelial Growth Factor, RAF Kinase, and Mammalian Target of Rapamycin Combination Targeted Therapy With Bevacizumab, Sorafenib, and Temsirolimus in Advanced Renal Cell Carcinoma—A Trial of the ECOG–ACRIN Cancer Research Group (E2804)

2015 ◽  
Vol 33 (21) ◽  
pp. 2384-2391 ◽  
Author(s):  
Keith T. Flaherty ◽  
Judith B. Manola ◽  
Michael Pins ◽  
David F. McDermott ◽  
Michael B. Atkins ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Progression Free Survival ◽  
Vegf Receptor ◽  
Vascular Endothelial ◽  
Free Survival ◽  
Endothelial Growth Factor

Purpose On the basis of evidence that resistance to vascular endothelial growth factor (VEGF) receptor inhibition is caused by hypoxia-driven residual VEGF and other proangiogenic factors, combinations of agents from these classes were hypothesized to improve treatment outcomes relative to single-agent VEGF pathway blockade. Patients and Methods A total of 361 patients with metastatic clear cell renal cell carcinoma were randomly assigned equally to arm A (bevacizumab monotherapy 10 mg/kg intravenously [IV] every 2 weeks), B (bevacizumab 10 mg/kg IV every 2 weeks and temsirolimus 25 mg IV every week), C (bevacizumab 5 mg/kg IV every 2 weeks and sorafenib 200 mg orally twice daily on days 1 to 5, 8 to 12, 15 to 19, and 22 to 26), or D (sorafenib 200 mg twice daily and temsirolimus 25 mg IV weekly). Progression-free survival was the primary end point. Results Among 331 eligible treated patients, median PFS was 7.5 months for bevacizumab alone (90% CI, 5.8 to 10.8 months), 7.6 months for bevacizumab plus temsirolimus (90% CI, 6.7 to 9.2 months), 9.2 months for bevacizumab plus sorafenib (90% CI, 7.5 to 11.4 months), and 7.4 months for sorafenib plus temsirolimus (90% CI, 5.6 to 7.9 months). Hazard ratios from stratified Cox proportional hazards models were 1.01, 0.89, and 1.07 (with respective P values of .95, .49, and .68) for the three combinations, respectively, compared with bevacizumab alone. Adverse events did not differ significantly among treatment arms. Conclusion The activity of sorafenib, temsirolimus, and bevacizumab administered in doublet combinations did not significantly improve median progression-free survival in comparison with bevacizumab monotherapy.

scholarly journals Prognostic Value of Vascular Endothelial Growth Factor A in the Prediction of the Tumor Aggressiveness in Clear Cell Renal Cell Carcinoma

2017 ◽  
Vol 5 (2) ◽  
pp. 167-172 ◽  
Author(s):  
Fahredin Veselaj ◽  
Suzana Manxhuka-Kerliu ◽  
Arber Neziri ◽  
Labinot Shahini ◽  
Shefki Xharra ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Renal Cell ◽  
Prognostic Value ◽  
Clear Cell ◽  
Vascular Endothelial ◽  
Cell Renal Cell Carcinoma ◽  
Free Survival ◽  
Endothelial Growth Factor

BACKGROUND: Clear cell renal cell carcinoma (CCRCC) is the most predominant renal tumour with unpredictable tumour behaviour. The aim of the study is to investigate the prognostic value of vascular endothelial growth factor A (VEGF-A) expression in CCRCC and to correlate it with other histological parameters as well as with patient's survival.MATERIAL AND METHODS: Tumour blocks were taken from 40 patients with histopathology diagnosis of CCRCC and tissue block from 20 normal kidneys as a control group were examined using the immuno-histochemical staining for VEGF-A.RESULTS: The VEGF A expression in CCRCC was significantly higher than in the normal kidney tissues (U’ = 720, P < 0.0001). VEGF A expression values in CCRCC were positively correlated with Disease Free Survival (r = 0.335, P = 0.034) and the tumor necrosis degree (r = 0.181, P = 0.262). VEGF-A expression values in CCRCC did not correlate with CD 31 expression (r = -0.09, P = 0.549), and Progression Free Survival (r = -0.07, P = 0.838). VEGF A expression values in CCRCC were negatively correlated with the tumor nuclear grade (r = -0.161, P = 0.318); the pathological tumor stage (r = -0.371, P = 0.018); the tumor size (r = -0.361, P = 0.022); the degree of tumor hemorrhage (r = -0.235, P = 0.143); and Cancer Specific Survival   (r = -0.207, P = 0.713).CONCLUSIONS: VEGF-A expression can be used to stratify advanced and metastatic CCRCC patients into low-benefit and high-benefit groups. Based on this study outcome it would be useful to perform IHC staining for VEGF-A expression in all patients with advanced and metastatic CCRCC.

scholarly journals The efficacy of lenvatinib plus everolimus in patients with metastatic renal cell carcinoma exhibiting primary resistance to front-line targeted therapy or immunotherapy

2020 ◽  
Vol 16 (3) ◽  
pp. 53-61
Author(s):  
L. Hamieh ◽  
R. L. Beck ◽  
V. H. Le ◽  
J. J. Hsieh
Keyword(s):  
Renal Cell Carcinoma ◽  
Vascular Endothelial Growth Factor ◽  
Targeted Therapy ◽  
Growth Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Vascular Endothelial ◽  
Front Line ◽  
Primary Resistance ◽  
Endothelial Growth Factor

Введение. Пациенты с первично резистентным метастатическим почечно-клеточным раком (мПКР) обычно имеют плохой прогноз заболевания с плохим ответом на последующее лечение. Несмотря на то что в настоящее время существует несколько одобренных схем 2-й линии терапии мПКР, вопрос выбора наиболее эффективной среди них остается открытым.Материалы и методы. Мы идентифицировали 7 пациентов со светлоклеточным вариантом мПКР и первичной резистентностью к ингибиторам тирозинкиназы (ИТК) рецепторов сосудистого эндотелиального фактора роста (vascular endothelial growth factor, VEGF) или к комбинированной терапии ингибиторами иммунных контрольных точек (ИИКТ). Пациенты получали ленватиниб (многоцелевой ИТК) в комбинации с эверолимусом (ингибитор мишени рапамицина млекопитающих). Всем участникам исследования ранее было выполнено лечение: 2 пациента получали ИТК, 3 пациента — ИИКТ, 2 пациента — ИТК и ИИКТ. Мы проанализировали клинические характеристики пациентов, их молекулярно-генетические профили, продолжительность лечения, его результаты, а также нежелательные явления.Результаты. Медиана времени до прогрессирования на фоне предшествующей терапии составила 1,5 мес. Пациенты получали комбинацию ленватиниб + эверолимус в рамках терапии 2-й (n = 4) или 3-й (n = 3) линии. У 3 пациентов достигнут частичный ответ, у 3 больных зафиксирована стабилизация заболевания. Длительность наблюдения составила ≥ 17 мес. Выживаемость без прогрессирования — 3—15мес, общая выживаемость — 4—17 мес.Заключение. Представленные в настоящей статье 7 случаев демонстрируют реальные результаты применения комбинации ленватиниб + эверолимус у пациентов со светлоклеточным мПКР и первичной резистентностью к ИТК VEGF или к комбинированной терапии ИИКТ.

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