Deferred systemic therapy in patients with metastatic renal cell carcinoma

Clinical Genitourinary Cancer
Aaron P MitchellDaniel J George

Abstract

With the advent of small-molecule "targeted" therapies, the prevailing treatment paradigm for metastatic renal cell carcinoma (mRCC) is that all patients who are able to tolerate systemic therapy should receive it. However, oncologists often defer the initiation of systemic therapy for patients with mRCC. The outcomes of and clinical reasoning behind the initial management of patients with mRCC without systemic therapy have not been well described. We conducted a retrospective cohort study of all patients with mRCC treated within the Duke University Health System and diagnosed from January 1, 2007, to January 1, 2011. We defined our cohort as patients who did not receive systemic therapy during the first year after mRCC diagnosis. The clinical rationale for the lack of immediate treatment was ascertained by manual chart review. A total of 60 of 268 patients (22%) with mRCC managed without initial systemic therapy were included in our study. The median age was 61.2 years, the median duration from diagnosis of localized RCC to development of mRCC was 41.9 months, and 91% of patients had Eastern Cooperative Oncology Group functional status of ≤ 1. Of the patients, 60% were managed with surgical metastasectomy alone, 12% received m...Continue Reading

References

Dec 1, 1982·American Journal of Clinical Oncology·M M OkenP P Carbone
Mar 11, 1999·European Urology·H G van der PoelF M Debruyne
May 9, 2002·The Annals of Thoracic Surgery·Stefan PiltzHeinrich Fuerst
Nov 21, 2002·The Annals of Thoracic Surgery·Joachim PfannschmidtHendrik Dienemann
Aug 28, 2003·Current Treatment Options in Oncology·Robert C FlaniganMaria M Picken
Jun 22, 2005·European Urology·Hans-Stefan HofmannRolf-Edgar Silber
Jul 1, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Scott E EggenerPaul Russo
Sep 25, 2007·The Annals of Thoracic Surgery·Jalal AssouadMarc Riquet
Oct 15, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Daniel Y C HengToni K Choueiri
Dec 21, 2010·The Journal of Urology·Jose A KaramNizar M Tannir
Dec 6, 2012·Current Urology Reports·Börje Ljungberg
Apr 20, 2014·World Journal of Urology·Dae Y KimChristopher G Wood

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Citations

Dec 15, 2015·Expert Review of Anticancer Therapy·Elisa ZanardiGiuseppe Procopio
Sep 21, 2018·American Society of Clinical Oncology Educational Book·Jeffrey GrahamUlka Vaishampayan
Jul 30, 2016·Current Opinion in Urology·Saeed DabestaniAxel Bex

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