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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2018.671    [Accepted]
Temsirolimus in Asian Metastatic/Recurrent Non-clear Cell Renal Carcinoma
Jii Bum Lee1,2, Hyung Soon Park3, Sejung Park4, Hyo Jin Lee5, Kyung A Kwon6, Young Jin Choi7, Yu Jung Kim8, Chung Mo Nam9, Nam Hoon Cho10, Beodeul Kang1,2,11, Hyun Cheol Chung1,2,11, Sun Young Rha1,2,11
1Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
2Song-Dang Institute for Cancer Research, Yonsei University College of Medicine, Seoul, Korea
3Division of Medical Oncology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
4Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
5Department of Internal Medicine, Chungnam National University, Daejeon, Korea
6Division of Hematology-Oncology, Department of Internal Medicine, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
7Division of Hematology-Oncology, Pusan National University, Pusan, Korea
8Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
9Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea
10Division of Pathology, Yonsei University College of Medicine, Seoul, Korea
11Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea
Correspondence  Sun Young Rha ,Tel: 82-2-2228-8053 , Fax: 82-2-362-5592 , Email: rha7655@yuhs.ac
Received: December 3, 2018;  Accepted: April 8, 2019.  Published online: April 16, 2019.
ABSTRACT
Purpose
Temsirolimus is effective in the treatment for metastatic non-clear cell renal cell carcinoma (nccRCC) with poor prognosis. We aim to investigate the efficacy and tolerability of temsirolimus in treatment of naïve Asian patients with metastatic/recurrent nccRCC.
Materials and Methods
From January 2008 to July 2017, data of treatment-naïve, metastatic/recurrent nccRCC patients, who were treated with temsirolimus according to the standard protocol, were collected. The primary end point was progression-free survival (PFS). Secondary end points were overall survival (OS), objective response rate (ORR), and tolerability of temsirolimus.
Results
Forty-four metastatic/recurrent nccRCC patients, 10 from prospective and 34 from retrospective groups, were enrolled; 24 patients (54%) were papillary type, and other histology subtypes included 11 (25%) chromophobe, 2 (5%) collecting duct, 1 (2%) Xp11.2 translocation, and 6 (14%) others. The median PFS and OS were 7.6 and 17.6 months, respectively. ORR was 11% and disease control rate was 83%. Patients with prior nephrectomy had longer PFS (HR 0.16; 95% confidence interval [CI], 0.06 to 0.42; p<0.001) and OS (HR, 0.15; 95% CI, 0.05 to 0.45; p<0.001). Compared to favorable/intermediate prognosis group, poor prognosis group had shorter median PFS (4.7 months vs. 7.6 months [HR, 2.91; 95% CI, 1.39 to 6.12, p=0.005] and median OS (9.2 months vs. 17.6 months [HR, 2.84; 95% CI, 1.23 to 6.56, p=0.015]).
Conclusion
Temsirolimus not only benefits poor-risk nccRCC patients, but it is also effective in favorable or intermediate risk group in Asians. Temsirolimus was well-tolerated with manageable adverse events.
Key words: Temsirolimus, First-line, Asian, Renal cell carcinoma, Efficacy, Tolerability
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