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Corianò M, Giannarelli D, Scartabellati G, De Giorgi U, Brighi N, Fornarini G, Tommasi C, Giudice GC, Rebuzzi SE, Puglisi S, Caffo O, Kinspergher S, Mennitto A, Cattrini C, Santoni M, Verzoni E, Rametta A, Stellato M, Malgeri A, Roviello G, Brunelli M, Signori A, Banna GL, Buti S. Tailoring treatment with cabozantinib or pazopanib in patients with metastatic renal cell carcinoma: does it affect outcome? Expert Rev Anticancer Ther 2023; 23:545-554. [PMID: 37017710 DOI: 10.1080/14737140.2023.2200168] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
BACKGROUND Metastatic renal cell carcinoma (mRCC) treatment is still largely based on TKI use. Treatment adjustment due to toxicities is often needed. The aim of the present study was to determine the impact of treatment modifications on the outcome of mRCC patients treated with cabozantinib or pazopanib.Research design and methods. This retrospective multicenter study enrolled consecutive patients receiving cabozantinib or pazopanib between January 2012 and December 2020. We evaluated the correlation of TKI treatment modifications with grade 3-4 toxicities and progression-free (PFS) and overall survival (OS). We also performed a landmark analysis excluding patients who did not undergo at least 5 months of therapy. RESULTS Among 301 patients, 179 (59%) were treated with pazopanib, 122 (41%) with cabozantinib. Treatment modifications were related to grade 3-4 toxicities (p < 0.0001). We observed a statistically significant longer PFS and OS in patients who underwent dose reductions (p < 0.0001 for both PFS and OS), temporary interruption (p < 0.0001 for both PFS and OS) and schedule modifications (p = 0.007 for PFS and p = 0.012 for OS) at univariate analysis. These results were confirmed at multivariable and landmark analyses. CONCLUSIONS Tailoring treatment with pazopanib and cabozantinib was associated with better PFS/OS.
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Affiliation(s)
- Matilde Corianò
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Italy
- Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC), Parma, Italy
| | - Diana Giannarelli
- Facility of Epidemiology, & Biostatistic, G-STeP Generator, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | | | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Nicole Brighi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Chiara Tommasi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Italy
- Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC), Parma, Italy
| | - Giulia Claire Giudice
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Italy
| | - Sara Elena Rebuzzi
- Medical Oncology Unit, Ospedale San Paolo, Savona, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, Italy
| | - Silvia Puglisi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Orazio Caffo
- Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy
| | | | - Alessia Mennitto
- Division of Oncology, University Hospital "Maggiore della Carità", Novara, Italy
| | - Carlo Cattrini
- Division of Oncology, University Hospital "Maggiore della Carità", Novara, Italy
| | | | - Elena Verzoni
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Rametta
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marco Stellato
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Medical Oncology, Fondazione Policlinico Campus Bio-Medico, Roma, Italy
| | - Andrea Malgeri
- Department of Medical Oncology, Fondazione Policlinico Campus Bio-Medico, Roma, Italy
| | | | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genova, Genoa, Italy
| | - Giuseppe Luigi Banna
- Department of Oncology, Portsmouth Hospitals University NHS Trust, PO6 3LY, Cosham, Portsmouth, UK
| | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Italy
- Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC), Parma, Italy
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