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Everolimus Versus Temsirolimus in Metastatic Renal Cell Carcinoma After Progression With Previous Systemic Therapies.

Abstract：

BACKGROUND:Everolimus is an approved agent for use after disease progression with vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) in patients with metastatic renal cell carcinoma. With recently published trials showing efficacy of nivolumab and cabozantinib in the second-line therapy setting, the use of everolimus will likely move to the third- or fourth-line therapy setting. Temsirolimus has occasionally been used instead of everolimus for many reasons, including financial considerations, assurance of patient compliance given its intravenous administration, its toxicity profile, patient performance status, and patient or physician preference. However, efficacy of everolimus and temsirolimus in this setting have not been compared in a randomized trial. The results from retrospective studies have been inconsistent. MATERIALS AND METHODS:We identified patients treated with a first-line VEGFR-TKI for metastatic renal cell carcinoma and then treated with either everolimus or temsirolimus on progression from the databases of 2 large academic cancer centers. Progression-free survival (PFS) and overall survival (OS) were assessed from the initiation of second-line treatment using the Kaplan-Meier method. RESULTS:A total of 90 patients received either everolimus (n = 59; 66%) or temsirolimus (n = 31; 34%) after progression during first-line VEGFR-TKI therapy. The patient and disease characteristics were similar in both groups. The median PFS was not different, but OS was superior with everolimus compared with temsirolimus (24.2 months vs. 12.1 months; hazard ratio, 0.58; P = .047). CONCLUSION:Our results bolster existing guidelines supporting everolimus over temsirolimus as salvage therapy after previous systemic therapies.

journal_name

Clin Genitourin Cancer

journal_title

Clinical genitourinary cancer

authors

Patel SB,Stenehjem DD,Gill DM,Tantravahi SK,Agarwal AM,Hsu J,Vuong W,Pal SK,Agarwal N

doi

10.1016/j.clgc.2015.12.011

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

153-9

issue

2

eissn

1558-7673

issn

1938-0682

pii

S1558-7673(15)00341-9

journal_volume

14

pub_type

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