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- Title
Clinical and Pathological Characteristics of Metastatic Renal Cell Carcinoma Patients Needing a Second-Line Therapy: A Systematic Review.
- Authors
Longo, Nicola; Capece, Marco; Celentano, Giuseppe; La Rocca, Roberto; Califano, Gianluigi; Collà Ruvolo, Claudia; Buonerba, Carlo; Esposito, Fabio; Napolitano, Luigi; Mangiapia, Francesco; Fusco, Ferdinando; Mirone, Vincenzo; Creta, Massimiliano
- Abstract
Simple Summary: The management of metastatic renal cell carcinoma (mRCC) represents a clinical challenge. Progression or toxicity may occur during first-line treatments and many patients require a second-line option. Given the expanding options for second-line therapies clinicians are faced with the challenge to individualize treatment. We performed a systematic review in order to summarize available evidences about the clinicopathological profile of mRCC patients who receive a second-line therapy. We identified twenty-nine studies enrolling 7650 patients. Discontinuation of first-line therapy was due to progression in the majority of patients with 77.8% patients harboring ≥2 metastatic sites. Most patients had a good performance status, their age ranged from 55 to 70 years and their prognostic profile revealed a good or intermediate disease in most cases. Tailoring of second-line treatment strategies based on these features is strongly advocated. A high percentage of patients with metastatic renal cell carcinoma (mRCC) require a second-line option. We aimed to summarize available evidences about the clinicopathological profile of mRCC patients who receive a second-line therapy. A systematic review was performed in August 2020. We included papers that met the following criteria: original research; English language; human studies; enrolling mRCC patients entering a second-line therapy. Twenty-nine studies enrolling 7650 patients (73.5% male, mean age: 55 to 70 years) were included. Clear cell histology was reported in 74.4% to 100% of cases. Tyrosine kinase inhibitors, immunotherapy, bevacizumab, mTOR inhibitors, and chemotherapy were adopted as first line option in 68.5%, 29.2%, 2.9%, 0.6%, and 0.2% of patients, respectively. Discontinuation of first-line therapy was due to progression and toxicity in 18.4% to 100% and in 17% to 48.8% of patients, respectively. Eastern Cooperative Oncology Group performance status score was 0 or 1 in most cases. Most prevalent prognostic categories according to the International Metastatic RCC Database Consortium and Memorial Sloan–Kettering Cancer Centre score were intermediate and good. About 77.8% of patients harboured ≥2 metastatic sites. In conclusion, patients who enter a second-line therapy are heterogeneous in terms of a clinical-pathological profile. Tailoring of second-line treatment strategies is strongly advocated.
- Subjects
THERAPEUTIC use of antineoplastic agents; CANCER chemotherapy; DRUG toxicity; HISTOLOGY; IMMUNOTHERAPY; METASTASIS; RENAL cell carcinoma; SYSTEMATIC reviews; PROTEIN-tyrosine kinase inhibitors; BEVACIZUMAB; DISEASE progression; DESCRIPTIVE statistics
- Publication
Cancers, 2020, Vol 12, Issue 12, p3634
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers12123634