Efficacy of sunitinib re-exposure after failure of an mTOR inhibitor in patients with metastatic RCC
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Efficacy of sunitinib re-exposure after failure of an mTOR inhibitor in patients with metastatic RCC. / Grünwald, Viktor; Weikert, Steffen; Seidel, Christoph; Busch, Jonas; Johannsen, Antje; Fenner, Martin; Reuter, Christoph; Ganser, Arnold; Johannsen, Manfred.
In: ONKOLOGIE, Vol. 34, No. 6, 2011, p. 310-4.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Efficacy of sunitinib re-exposure after failure of an mTOR inhibitor in patients with metastatic RCC
AU - Grünwald, Viktor
AU - Weikert, Steffen
AU - Seidel, Christoph
AU - Busch, Jonas
AU - Johannsen, Antje
AU - Fenner, Martin
AU - Reuter, Christoph
AU - Ganser, Arnold
AU - Johannsen, Manfred
N1 - Copyright © 2011 S. Karger AG, Basel.
PY - 2011
Y1 - 2011
N2 - BACKGROUND: The sequential use of tyrosine kinase inhibitors (TKI) followed by mTOR inhibitors (mTORi) has been recently established for the systemic treatment of metastatic renal cell carcinoma (mRCC). However, subsequent treatment in mTORi-refractory disease remains undetermined. We analyzed the efficacy of sunitinib re-challenge after failure of an mTORi at 2 German centers.PATIENTS AND METHODS: Thirteen patients who failed both sunitinib and an mTORi were analyzed, and all patients were re-exposed to sunitinib. Tumor assessment was performed every 2nd cycle of sunitinib or every 3 months. Tumor response was assessed according to RECIST criteria.RESULTS: Initial treatment with sunitinib was associated with a median progression free survival (PFS) of 21 months. Objective response consisted of 2 (15%) complete remissions and 7 (54%) partial remissions (PR) as best response. At the time of re-exposure, 12 of 13 (92%) patients again showed clinical benefit which was associated with a median PFS of 6.9 months and consisted of 2 (15%) PR and 10 (77%) disease stabilizations.CONCLUSIONS: In sunitinib-responsive patients, re-challenge with sunitinib has been successfully introduced after mTORi-refractory disease, underscoring the at least partially transient nature of TKI resistance in mRCC.
AB - BACKGROUND: The sequential use of tyrosine kinase inhibitors (TKI) followed by mTOR inhibitors (mTORi) has been recently established for the systemic treatment of metastatic renal cell carcinoma (mRCC). However, subsequent treatment in mTORi-refractory disease remains undetermined. We analyzed the efficacy of sunitinib re-challenge after failure of an mTORi at 2 German centers.PATIENTS AND METHODS: Thirteen patients who failed both sunitinib and an mTORi were analyzed, and all patients were re-exposed to sunitinib. Tumor assessment was performed every 2nd cycle of sunitinib or every 3 months. Tumor response was assessed according to RECIST criteria.RESULTS: Initial treatment with sunitinib was associated with a median progression free survival (PFS) of 21 months. Objective response consisted of 2 (15%) complete remissions and 7 (54%) partial remissions (PR) as best response. At the time of re-exposure, 12 of 13 (92%) patients again showed clinical benefit which was associated with a median PFS of 6.9 months and consisted of 2 (15%) PR and 10 (77%) disease stabilizations.CONCLUSIONS: In sunitinib-responsive patients, re-challenge with sunitinib has been successfully introduced after mTORi-refractory disease, underscoring the at least partially transient nature of TKI resistance in mRCC.
KW - Aged
KW - Antineoplastic Agents
KW - Carcinoma, Renal Cell
KW - Female
KW - Humans
KW - Indoles
KW - Kidney Neoplasms
KW - Male
KW - Middle Aged
KW - Pyrroles
KW - TOR Serine-Threonine Kinases
KW - Treatment Failure
KW - Treatment Outcome
U2 - 10.1159/000328575
DO - 10.1159/000328575
M3 - SCORING: Journal article
C2 - 21625184
VL - 34
SP - 310
EP - 314
JO - ONKOLOGIE
JF - ONKOLOGIE
SN - 0378-584X
IS - 6
ER -
