BACKGROUND Non-clear cell(ncc)metastatic renal-cell carcinoma(RCC)has dismal results with standard systemic therapies and a generally worse prognosis when compared to its clear-cell counterpart.New systemic combinatio...BACKGROUND Non-clear cell(ncc)metastatic renal-cell carcinoma(RCC)has dismal results with standard systemic therapies and a generally worse prognosis when compared to its clear-cell counterpart.New systemic combination therapies have emerged for metastatic RCC(mRCC),but the pivotal phase III trials excluded patients with nccRCC,which constitute about 30%of metastatic RCC cases.AIM To provide a piece of real-life evidence on the use of pazopanib in this patient subgroup.METHODS The present study is a multicenter retrospective observational analysis aiming to assess the activity,efficacy,and safety of pazopanib as first-line therapy for advanced nccRCC patients treated in a real-life setting.RESULTS Overall,48 patients were included.At the median follow-up of 40.6 mo,the objective response rate was 27.1%,the disease control rate was 83.3%,and the median progression-free survival and overall survival were 12.3(95%confidence interval[CI]:3.6-20.9)and 27.7(95%CI:18.2-37.1)mo,respectively.Grade 3 adverse events occurred in 20%of patients,and no grade 4 or 5 toxicities were found.CONCLUSION Pazopanib should be considered as a good first-line option for metastatic RCC with variant histology.展开更多
<strong><u>Background:</u></strong> Non-clear cell renal cell carcinomas represent a very rare and heterogeneous variety of kidney cancer. The aim of this study is to describe the main epidemio...<strong><u>Background:</u></strong> Non-clear cell renal cell carcinomas represent a very rare and heterogeneous variety of kidney cancer. The aim of this study is to describe the main epidemiological, clinical, paraclinical, histological and therapeutic characteristics of these cancers. <strong><u>Methods:</u></strong> A descriptive retrospective study was conducted in the Medical Oncology Department of the Hassan II Hospital in Fez, collecting 23 patients with these tumors during the period from January 2008 to January 2020. The statistical analysis is made by the SPSS software version 23. Survival was calculated by the Kaplan-Meier method. <strong><u>Results:</u></strong> The average age of the patients was 57.4 years. The sex ratio M/F was 1.3. The main risk factor was smoking (n = 10). The most common symptom was low back pain (n = 23). 17 patients were metastatic, while 6 patients had localized disease. The most common histological type was papillary carcinoma (n = 12). Patients with localized disease have undergone an extended total nephrectomy. After a median follow-up of 145 months, the median of recurrence-free survival was 48 months and that of overall survival was 150 months. In a metastatic situation, 16 patients had received systemic treatment, of which 13 patients had received sunitinib, 2 patients pazaopanib and only one patient received everolimus. After a median follow-up of 20 months, the median of progression-free survival was 5 months and that of overall survival was 9 months. <strong><u>Conclusion:</u></strong> At the present time, there is no therapeutic standard for the management of patients with these tumors. Surgery for people with localized or locally advanced disease remains the initial and most important approach. For patients with advanced disease, a clinical trial should be considered.展开更多
Management of kidney cancer has undergone a paradigm shift with the approval of new therapies over the last two decades.Although these drugs have improved clinical outcomes in patients with kidney cancer,there are sti...Management of kidney cancer has undergone a paradigm shift with the approval of new therapies over the last two decades.Although these drugs have improved clinical outcomes in patients with kidney cancer,there are still a large number of patients who do not show objective responses.A multitude of investigators,including those for The Cancer Genome Atlas have biologically characterized and sub-classified kidney cancer.However,we have not been able to identify molecular targets to effectively treat patients with kidney cancer.As we familiarize ourselves with newer drugs for patients with kidney cancer,it is important to understand that these drugs may not work in every patient and instead may expose patients to unnecessary toxic effects along with burdening society with the financial impact.As we head toward the era of“precision medicine”,validated biomarkers are being utilized to guide treatment choices and help identify pathways of resistance in other tumor types.The current review aims at evaluating the progress made so far in this realm for patients with kidney cancer.展开更多
文摘BACKGROUND Non-clear cell(ncc)metastatic renal-cell carcinoma(RCC)has dismal results with standard systemic therapies and a generally worse prognosis when compared to its clear-cell counterpart.New systemic combination therapies have emerged for metastatic RCC(mRCC),but the pivotal phase III trials excluded patients with nccRCC,which constitute about 30%of metastatic RCC cases.AIM To provide a piece of real-life evidence on the use of pazopanib in this patient subgroup.METHODS The present study is a multicenter retrospective observational analysis aiming to assess the activity,efficacy,and safety of pazopanib as first-line therapy for advanced nccRCC patients treated in a real-life setting.RESULTS Overall,48 patients were included.At the median follow-up of 40.6 mo,the objective response rate was 27.1%,the disease control rate was 83.3%,and the median progression-free survival and overall survival were 12.3(95%confidence interval[CI]:3.6-20.9)and 27.7(95%CI:18.2-37.1)mo,respectively.Grade 3 adverse events occurred in 20%of patients,and no grade 4 or 5 toxicities were found.CONCLUSION Pazopanib should be considered as a good first-line option for metastatic RCC with variant histology.
文摘<strong><u>Background:</u></strong> Non-clear cell renal cell carcinomas represent a very rare and heterogeneous variety of kidney cancer. The aim of this study is to describe the main epidemiological, clinical, paraclinical, histological and therapeutic characteristics of these cancers. <strong><u>Methods:</u></strong> A descriptive retrospective study was conducted in the Medical Oncology Department of the Hassan II Hospital in Fez, collecting 23 patients with these tumors during the period from January 2008 to January 2020. The statistical analysis is made by the SPSS software version 23. Survival was calculated by the Kaplan-Meier method. <strong><u>Results:</u></strong> The average age of the patients was 57.4 years. The sex ratio M/F was 1.3. The main risk factor was smoking (n = 10). The most common symptom was low back pain (n = 23). 17 patients were metastatic, while 6 patients had localized disease. The most common histological type was papillary carcinoma (n = 12). Patients with localized disease have undergone an extended total nephrectomy. After a median follow-up of 145 months, the median of recurrence-free survival was 48 months and that of overall survival was 150 months. In a metastatic situation, 16 patients had received systemic treatment, of which 13 patients had received sunitinib, 2 patients pazaopanib and only one patient received everolimus. After a median follow-up of 20 months, the median of progression-free survival was 5 months and that of overall survival was 9 months. <strong><u>Conclusion:</u></strong> At the present time, there is no therapeutic standard for the management of patients with these tumors. Surgery for people with localized or locally advanced disease remains the initial and most important approach. For patients with advanced disease, a clinical trial should be considered.
基金the National Center for Advancing Translational Sciences of the National Institutes of Health,under Award Number 2KL2TR001426-05A1.
文摘Management of kidney cancer has undergone a paradigm shift with the approval of new therapies over the last two decades.Although these drugs have improved clinical outcomes in patients with kidney cancer,there are still a large number of patients who do not show objective responses.A multitude of investigators,including those for The Cancer Genome Atlas have biologically characterized and sub-classified kidney cancer.However,we have not been able to identify molecular targets to effectively treat patients with kidney cancer.As we familiarize ourselves with newer drugs for patients with kidney cancer,it is important to understand that these drugs may not work in every patient and instead may expose patients to unnecessary toxic effects along with burdening society with the financial impact.As we head toward the era of“precision medicine”,validated biomarkers are being utilized to guide treatment choices and help identify pathways of resistance in other tumor types.The current review aims at evaluating the progress made so far in this realm for patients with kidney cancer.
