Sequential Therapy With Sorafenib and Sunitinib in Renal Cell Carcinoma
Sequential Therapy With Sorafenib and Sunitinib in Renal Cell Carcinoma
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DOI：
10.1002/cncr.24009
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发表时间：
2009-01-01
期刊：
影响因子：
6.2
通讯作者：
Szczylik, Cezary
中科院分区：
文献类型：
--
作者：
Dudek, Arkadiusz Z.;Zolnierek, Jakub;Szczylik, Cezary
背景：舒尼替尼和索拉非尼均为小分子酪氨酸激酶抑制剂（TKI），对晚期肾细胞癌具有抗肿瘤活性。我们进行了一项回顾性研究，以评估肾细胞癌对这两种药物序贯治疗的反应。方法：在舒尼替尼或索拉非尼一线治疗失败，随后接受其他TKI药物二线治疗的患者中，使用实体瘤疗效评价标准（RECIST）标准评价肿瘤缓解。结果：A组29例先用索拉非尼B，后用舒尼替尼; B组20例先用舒尼替尼，后用索拉非尼B。A组6例（12%）患者和B组4例（8%）患者因毒性终止TKI药物治疗。A组和B组疾病稳定的中位持续时间分别为20周和9.5周。A组和B组从开始首次TKI至第二次TKI后疾病进展的中位时间（至进展时间）分别为78周和37周。多变量分析显示，B组的进展时间短于A组（风险比[RR] 3.0; P= 0.016）。A组和B组的中位总生存期分别为102周和45周（P= 0.061）。结论：接受索拉非尼治疗后接受舒尼替尼治疗的患者疾病控制持续时间更长，值得进一步研究。Cancer 2009;115：61-7. (C)2008美国癌症协会
BACKGROUND: Sunitinib and sorafenib are small-molecule tyrosine kinase inhibitors (TKI) with antitumor activity in advanced renal cell carcinoma. A retrospective study was conducted to assess the response of renal cell carcinoma to sequential treatment with these two agents. METHODS: Tumor response was evaluated by using Response Evaluation Criteria In Solid Tumors (RECIST) criteria in patients failing first-line therapy with either sunitinib or sorafenib and subsequently receiving second-line therapy with the other TKI agent. RESULTS: Twenty-nine patients received sorafenib followed by sunitinib (Group A), and 20 patients received sunitinib followed by sorafenib (Group B). TKI drugs were terminated in 6 (12%) patients in Group A and 4 (8%) in Group B because of toxicity. Median duration of stable disease for Groups A and B was 20 and 9.5 weeks, respectively. Median time from starting first TKI to disease progression after second TKI (time to progression) in Groups A and B was 78 and 37 weeks, respectively. Multivariate analysis revealed that Group B had a shorter time to progression than Group A (risk ratio [RR] 3.0; P=.016). Median overall survival was 102 and 45 weeks in Groups A and B, respectively (P=.061). CONCLUSIONS: The longer duration of disease control in patients who received sorafenib followed by sunitinib warrants further investigation. Cancer 2009;115:61-7. (C) 2008 American Cancer Society.