230 likes | 304 Views
Explore the efficacy of axitinib vs. sorafenib in non-clear cell RCC, including clinical trials, adverse events, and survival data. Understand the impact of histology on treatment outcomes. Updated information on ongoing clinical trials and a multidisciplinary approach to patient care.
E N D
Systemic treatment for non-clearcellhistology Alessandra Mosca MedicalOncology «Maggiore della Carità» University Hospital University of East Piedmont “A. Avogadro” Novara
(+) (-) HIF, VEGF De Vita VT el al, 2005 Sporadic/hereditary (Sporadic)/hereditary (hereditary leiomyomatosis)
Histology clear cell clear cell clear cell 124 pts (20%) non-clear cell clear cell clear cell clear cell Axitinib vs Sorafenib 723 2nd line PFS 6.7 vs 4.7 mo (p<0.0001) clearcell 8Rini BI et al, Lancet 2011
NEW CLINICAL TRIALS FOR NON-CLEAR CELL RCC: COMPLETED -I-
NEW CLINICAL TRIALS FOR NON-CLEAR CELL RCC: COMPLETED -II-
894/2076 (43%) pts ineligible for clinical trials
25 non-clearcell 132 clearcell treated with TT: mediansurvival 15.4 mo (non-clear) vs 35 mo (clear) p=0.007 Non-clearcellhistology remains a significant and independent riskfactor for cancerspecificdeath for mRCCptstreated by TT
37 pts -> intermittent schedule 37 pts -> daily schedule Adverseevents: -Hypertension 50% -Pulmonaryembolism 11% -Fatigue 6.8% -Diarrhea 6.8%
67/74 ptsevaluable for both MET mutationand response to Foretinib: 5/10 (50%) ptswith germlineMET mutation: PR 5/10 (50%) ptswith germlineMET mutation: SD 5/57 (9%) ptswithout germlineMET mutation: PR 1/5 (20%) pts with somatic MET mutation: PR
Sporadic papillary RCC is different from hereditary papillary RCC?
CONCLUSIONS -I- Adapted from Cho D, ASCO GU 2012
CONCLUSIONS -II- Adapted from Cho D, ASCO GU 2012
CONCLUSIONS -III- Multidisciplinaryapproach to RCC patients (Pathologist, Urologist, Oncologist, Radiologist, Statistician, Nurse, …)