In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 33, No. 7_suppl ( 2015-03-01), p. 462-462
Abstract:
462 Background: In a subset of patients with metastatic renal cell carcinoma (RCC), primary resistance to first VEGF targeted therapy is not fully understood, and the optimal treatment approach for these patients is still controversial. This study was aimed to characterize the primary sunitinib resistant patients and associated predicting factors. Methods: A total of 134 patients with recurrent or metastatic RCC, who were initially treated with sunitinib, consecutively selected from 4 centers in Korea, between January 2008 and March 2013. Patients in whom progressive disease (PD) was the best response during treatment with sunitinib were included in the primary sunitinib resistant group. Results: Among 134 patients, 33 (25%) patients primary resistant to sunitinib with a median age of 59 years (range, 28-78) were identified. Most patients had clear cell histology (94%) and good ECOG performance status (0, 1) (82%). According to MSKCC risk, 25% of patients were at favorable risk, 72% at intermediate risk, and 3% at poor risk. Univariate analysis revealed that poor performance status (ECOG≥2), elevated LDH, neutrophilia, and higher number of distant metastatic disease (≥3) and bone or hepatic metastasis were significant factors associated with intrinsic resistant disease. Neutrophilia (OR=7.4, p=0.015) and more than three distant metastatic disease (OR=3.6, p=0.031) were independently significant risk factors of predicting intrinsic resistant disease on multivariate analysis. There was statistically significant difference with regard to overall survival (median, 11.7 vs. 31.1 month; p=0.001) and progression free survival (median, 2.4 vs. 12.5 month; p 〈 0.0001) between the patients with and without intrinsic resistance. Conclusions: Intrinsic resistance to sunitinib treatment is associated with a dismal prognosis in metastatic RCC patients. Along with above predicting clinical features, more understanding of the underlying mechanism and molecular biomarkers for detecting the intrinsic resistant disease are needed.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2015.33.7_suppl.462
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2015
detail.hit.zdb_id:
2005181-5
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