Stereotactic Radiotherapy for the Treatment of Patients With Oligo-progressive Metastatic Renal Cell Carcinoma Receiving Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor: Data From the Real World

Vittorio Gebbia, Vincenzo Serretta, Alberto Firenze, Maria Rosaria Valerio, Andrea Girlando, Nicolò Borsellino, Vittorio Gebbia, Ivan Fazio, Stefano Pergolizzi, Dario Piazza, Alfio D.I. Grazia, Antonio Pontoriero, Vincenzo Serretta, Alfio Di Grazia, Debora Piazza

Risultato della ricerca: Articlepeer review

Abstract

AIM: This retrospective observational study evaluated the role of hypo-fractionated stereotactic radiotherapy (SRT) in patients with oligo-progressive metastatic renal cell carcinoma (mRCC) treated with first-line oral tyrosine kinase inhibitors (TKI). Data on local control, delay of further progression, and safety are reported. PATIENTS AND METHODS: Between January 2010 and December 2016, 28 patients with mRCC who showed oligo-progressive disease while receiving first-line pazopanib were treated with hypofractionated SRT to progressive metastatic sites to delay the change of systemic therapy. First and second progression-free survival (PFS-1 and PFS-2) were recorded, as well as objective response and toxicity. RESULTS: After pazopanib therapy, nine partial remissions (32%), 12 stable disease (43%) and seven progressions (25%) were recorded. The median time to progression from first-line pazopanib until oligo-progression was 9.45 months (PFS-1 range=2-30 months). Seventeen patients (61%) showed progression at pre-existing tumor sites, and 11 patients (39%) showed the appearance of new metastases. Progression-free survival after radiation therapy was 4.55 months (PFS-2 range=1-11 months). PFS-1 plus PFS-2 was 14.0 months (range=3-41 months). Severe grade 3-4 toxicities were seen only occasionally. CONCLUSION: Patients with oligo-progressive mRCC treated with first-line pazopanib may benefit from hypo-fractionated high-dose SRT at progressing sites achieving a further increase in median progression-free survival. Further studies and prospective validation are required to establish if this minimally invasive approach may have a positive impact on overall survival and reported outcomes.
Lingua originaleEnglish
pagine (da-a)7037-7043
Numero di pagine7
RivistaAnticancer Research
Volume40
Stato di pubblicazionePublished - 2020

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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