Evidence map›Paper›PMID 26676614›Full record

ArticleWorld journal of urology2016

Efficacy of fourth-line targeted therapy in patients with metastatic renal cell carcinoma: a retrospective analysis.

Bernhard Ralla, Barbara Erber, Irena Goranova, Luise von der Aue, Anne Floercken, Stefan Hinz, Carsten Kempkensteffen, Ahmed Magheli, Kurt Miller, Jonas Busch

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Article in World journal of urology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Bernhard RallaDepartment of Urology, Charité Universitaetsmedizin Berlin, Charité Platz 1, 10117, Berlin, Germany. Bernhard.Ralla@charite.de.ORCID http://orcid.org/0000-0001-7226-3852
Barbara ErberDepartment of Urology, Charité Universitaetsmedizin Berlin, Charité Platz 1, 10117, Berlin, Germany.
Irena GoranovaDepartment of Urology, Charité Universitaetsmedizin Berlin, Charité Platz 1, 10117, Berlin, Germany.
Luise von der AueDepartment of Urology, Charité Universitaetsmedizin Berlin, Charité Platz 1, 10117, Berlin, Germany.
Anne FloerckenDepartment of Hematology, Oncology and Tumor Immunology, Charité Universitaetsmedizin Berlin, Berlin, Germany.
Stefan HinzDepartment of Urology, Charité Universitaetsmedizin Berlin, Charité Platz 1, 10117, Berlin, Germany.
Carsten KempkensteffenDepartment of Urology, Charité Universitaetsmedizin Berlin, Charité Platz 1, 10117, Berlin, Germany.
Ahmed MagheliDepartment of Urology, Charité Universitaetsmedizin Berlin, Charité Platz 1, 10117, Berlin, Germany.
Kurt MillerDepartment of Urology, Charité Universitaetsmedizin Berlin, Charité Platz 1, 10117, Berlin, Germany.
Jonas BuschDepartment of Urology, Charité Universitaetsmedizin Berlin, Charité Platz 1, 10117, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEvidence for sequencing targeted therapy (TT) in patients with metastatic renal cell carcinoma (mRCC) beyond third line is limited. Treatment decisions for these sequence options are largely based on individual preferences and experience. The aim of this study was to describe the efficacy and toxicity of fourth-line TT. MATERIALS AND

methodsWe retrospectively reviewed patients treated with fourth-line TT for mRCC after failure of previous treatment lines at a German academic high-volume center. Out of 406 patients treated in first line, 56 patients (14.8 %) were identified with more than three lines of TT. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox proportional hazards models were applied to explore predictors of PFS and OS in uni- and multivariable analysis.

resultsFor the fourth-line treatment, disease control rate was 35.7 %. Median OS from beginning of first-line therapy was 47.4 months (IQR 31.0-76.5). Primary resistance at first-line TT, metastatic disease at initial diagnosis and an intermediate MSKCC score were independent predictors of shorter OS from start of first-line TT. Median OS from the time of initiation of fourth-line therapy was 10.5 months (IQR 5.6-22.6). The corresponding median PFS for fourth-line TT was 3.2 months (IQR 1.6-8.0) and was not correlated with treatment response in first-line TT. The rate of toxicity-induced treatment termination was 16.1 %. Limitations are the retrospective and unicentric design with a limited number of patients.

conclusionsPatients might benefit from subsequent treatment lines independently from treatment response in first line.

Indexed as

AgedAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Renal CellDisease-Free SurvivalFemaleHumansKidney NeoplasmsMaleMiddle AgedRetrospective StudiesFourth-lineMetastasisRenal cell carcinomaTargeted therapyTKITyrosine kinase inhibitorVascular endothelial growth factor receptorVEGF

Identifiers

PMID26676614

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.