Documente Academic
Documente Profesional
Documente Cultură
2 NUMRUL
4 DECEMBRIE 2009
JCO 2009;27:3274-3276
Robert J. Motzer i Ana M. Molina, Memorial Sloan Kettering Cancer Center, New York, NY
2009
163
Motzer i Molina
Tabelul 1. Rezultatele de eficacitate ale tratamentului cu ageni intii n studiile de faz III n carcinomul renal avansat
Studiul
Nr. de
pacieni
Sorafenib vs
placebo2
903
Sunitinib vs
interferon-alfa4
750
Temsirolimus vs
interferon-alfa7
626
Bevacizumab +
interferon-alfa vs
interferon-alfa
(AVOREN)5
Bevacizumab +
interferon-alfa vs
interferon-alfa
(CALBG 90206)6
Everolimus vs
placebo8
649
732
410
Durata
HR
95% CI
SG median
prespecificat (luni)
Durata
HR
95% CI
Analiza exploratorie
a SG mediane (luni)
Durata
HR
5,5 vs 2,8* 0,44 0,35-0,55 17,8 vs 15,2 0,88 0,74-1,04 17,8 vs 14,3 0,78
95% CI
Obiectivul
principal
ndeplinit
0,62-0,97
SG; nu
11,0 vs 5,0* 0,44 0,32-0,54 26,4 vs 21,8 0,82 0,67-1,00 26,4 vs 20,0 0,808 0,66-0,99 SFP; da
5,5 vs 3,1*
Neefectuat
SG; da
Incomplet
Neefectuat
SG;
incomplet
8,5 vs 5,2
0,72 0,61-0,83
Incomplet
Neefectuat
SG;
incomplet
Incomplet
Neefectuat
SFP; da
Abrevieri: SFP, supravieuirea fr progresia bolii; SG, supravieuirea general; HR, hazard ratio; MSKCC, Memorial Sloan-Kettering Cancer Center; CALGB,
Cancer and Leukemia Group B; VEGF, factorul de cretere a endoteliului vascular (vascular endothelial growth factor).
NOT: Grupurile de risc definite drept: 0 factori de risc = favorabil; 1 - 2 factori de risc = intermediar; 3 factori de risc = rezervat.
*Evaluarea independent a supravieuirii fr progresia bolii.
Editorial
BIBLIOGRAFIE
1. Motzer RJ, Bander NH, Nanus DM: Renal-cell carcinoma. N Engl J Med
335:865-875, 1996
2. Escudier B, Eisen T, Stadler WM, et al: Sorafenib for treatment of renal
cell carcinoma: Final efficacy and safety results of the phase III Treatment Approaches in Renal Cancer Global Evaluation Trial. J Clin Oncol 27:3312-3318,
2009
3. Escudier B, Eisen T, Stadler WM, et al: Sorafenib in advanced clear-cell
renal-cell carcinoma. N Engl J Med 356:125-134, 2007
4. Motzer RJ, Hutson TE, Tomczak P, et al: Sunitinib versus interferon alfa
in metastatic renal-cell carcinoma. N Engl J Med 356:115-124, 2007
5. Escudier B, Pluzanska A, Koralewski P, et al: Bevacizumab plus interferon alfa-2a for treatment of metastatic renal-cell carcinoma: A randomised,
doubleblind phase III trial. Lancet 370:2103-2111, 2007
6. Rini BI, Halabi S, Rosenberg JE, et al: Bevacizumab plus interferon alfa
compared with interferon alfa monotherapy in patients with metastatic renal
cell carcinoma: CALGB 90206. J Clin Oncol 26:5422-5428, 2008
7. Hudes G, Carducci M, Tomczak P, et al: Temsirolimus, interferon alfa, or
both for advanced renal-cell carcinoma. N Engl J Med 356:2271-2281, 2007
8. Motzer RJ, Escudier B, Oudard S, et al: Efficacy of everolimus in advanced renal cell carcinoma: A double-blind, randomised, placebo-controlled
phase III trial. Lancet 372:449-456, 2008
9. Figlin RA, Hutson TE, Tomczak P, et al: Overall survival with sunitinib
versus interferon (IFN)-alfa as first-line treatment of metastatic renal cell carcinoma (mRCC). J Clin Oncol 26:256s, 2008 (suppl; abstr 5024)
10. Motzer RJ, Bacik J, Murphy BA, et al: Interferon-alfa as a comparative
treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol 20:289-296, 2002
11. Motzer RJ, Rini BI, Bukowski RM, et al: Sunitinib in patients with metastatic renal cell carcinoma. JAMA 295:2516-2524, 2006
12. National Comprehensive Cancer Network: NCCN Practice Guidelines.
http://www.nccn.org/professionals/physician_gls/PDF/kidney.pdf
13. Szczylik C, Demkow T, Staehler M, et al: Randomized phase II trial of
first-line treatment with sorafenib versus interferon in patients with advanced
renal cell carcinoma: Final results. J Clin Oncol 25:241s, 2007 (suppl; abstr
5025)
14. Hutson TE, Davis ID, Machiels JP, et al: Pazopanib (GS786034) is active
in metastatic renal cell carcinoma (RCC): Interim results of a phase II randomized discontinuation trial (RDT). J Clin Oncol 25:242s, 2007 (suppl; abstr
5031)
15. Rixe O, Bukowski RM, Michaelson MD, et al: Axitinib treatment in patients with cytokine-refractory metastatic renal-cell cancer: A phase II study.
Lancet Oncol 8:956-957, 2007
16. National Cancer Institute. http://www.cancer.gov
Mulumiri
Mulumim lui Carol Pearce, redactor n Departamentul de Medicin al Memorial Sloan Kettering Cancer Center,
pentru revizia manuscrisului.
www.jco.org
165