Prognostic factors for survival following initiation of second-line treatment with everolimus for metastatic renal cell carcinoma: evidence from a nationwide sample of clinical practice in the United States. (April 2015)

• Record Type: Journal Article
• Authors: Wong, Michael K; Jonasch, Eric; Pal, Sumanta K; Signorovitch, James E; Lin, Peggy L; Wang, Xufang; Liu, Zhimei; Culver, Ken; Scott, Jeffrey A; George, Daniel J; Vogelzang, Nicholas J
• Is Part Of: Expert opinion on pharmacotherapy. Volume 16:Number 6(2015)
• Page Start: 805
• Page End: 819
• Publication Date: 2015-04
• Subjects: everolimus -- metastatic renal cell carcinoma -- overall survival -- prognostic -- second-line -- targeted therapy -- tyrosine kinase inhibitor; Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1517/14656566.2015.1020298
• Languages: English
• ISSNs: 1465-6566

Abstract

Abstract : Objective: Comparing prognostic factors for overall survival (OS) in community-practice metastatic renal cell carcinoma (mRCC) patients receiving second-line everolimus with those previously reported in clinical trials. Research design and methods: Two separate chart sets (2009 – 2012) were used to develop and validate a prognostic model for patients initiating second-line everolimus after first-line tyrosine kinase inhibitor (TKI). Main outcome measures: Prognostic factors for OS have been identified and validated in separate samples. Results: One-year OS probabilities in the study (n = 220) and validation (n = 97) samples were 68 and 67%; median OS was 19 and 23 months – higher than the 1-year OS of 60% and median OS of 14.8 months of RECORD-1. Karnofsky performance score < 80%, duration of mRCC < 1 year, progression on first-line TKI, liver metastasis and clear cell histology were significant prognostic factors for shorter survival. One-year OS estimates were 84% for validation sample patients with 0 – 2 risk factors, 63% for 3 risk factors and 22% for 4 – 5 risk factors (log-rank p < 0.001). Conclusion: Real-world prognostic factors for OS following second-line everolimus for mRCC were largely consistent with those previously identified in trial data; however, OS was longer in the practice setting than in clinical trials and was not associated with type of first-line TKI.