With 15 drugs currently approved for the treatment of metastatic renal cell carcinoma (mRCC) and even more combination regimens with immunotherapy on the horizon, there remains a distinct lack of molecular biomarkers for therapeutic efficacy. Our study reports on real-world clinical outcomes of mRCC patients from a tertiary academic medical center treated with empirically selected standard-of-care therapy. We utilized the Stanford Renal Cell Carcinoma Database (RCCD) to report on various outcome measures, including overall survival (OS) and the median number of lines of targeted therapies received from the time of metastatic diagnosis. We found that most metastatic patients did not survive long enough to attempt even half of the available targeted therapies. We also noted that patients who failed to receive a clinical benefit within the first two lines of therapy could still go on to experience clinical benefit in later lines of therapy. The term, “clinical benefit” was assigned to a line of therapy if a patient remained on drug treatment for three months or longer. Moreover, patients with clinical benefit in at least one line of therapy experienced significantly longer OS compared to those who did not have clinical benefit in at least one line of therapy. Developing biomarkers that identify patients who will receive clinical benefit in individual lines of therapy is one potential strategy for achieving rational drug sequencing in mRCC.
Cancers. 2019 Jul 17*** epublish ***
Viola J Chen, Gabriela Hernandez-Meza, Prashasti Agrawal, Chiyuan A Zhang, Lijia Xie, Cynthia L Gong, Christian R Hoerner, Sandy Srinivas, Eric K Oermann, Alice C Fan
Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA., Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA., Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA., Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA., Department of Medicine, Highland Hospital, Oakland, CA 94602, USA., Division of Neonatology and the Fetal and Neonatal Institute, Children’s Hospital Los Angeles (CHLA), Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA., Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA., Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. .