Treatment patterns and outcomes in patients with unresectable or metastatic renal cell carcinoma in Japan

  • Kenichi Harada
    Division of Urology Department of Surgery Related Kobe University Graduate School of Medicine Kobe Japan
  • Masahiro Nozawa
    Department of Urology Kindai University Faculty of Medicine Osaka Japan
  • Motohide Uemura
    Department of Urology Osaka University Graduate School of Medicine Osaka Japan
  • Katsunori Tatsugami
    Department of Urology Graduate School of Medical Sciences Kyushu University Fukuoka Japan
  • Takahiro Osawa
    Department of Urology Hokkaido University Sapporo Japan
  • Kazutoshi Yamana
    Department of Urology, Molecular Oncology Graduate School of Medical and Dental Sciences Niigata University Niigata Japan
  • Go Kimura
    Department of Urology Nippon Medical School Tokyo Japan
  • Masato Fujisawa
    Division of Urology Department of Surgery Related Kobe University Graduate School of Medicine Kobe Japan
  • Norio Nonomura
    Department of Urology Osaka University Graduate School of Medicine Osaka Japan
  • Masatoshi Eto
    Department of Urology Graduate School of Medical Sciences Kyushu University Fukuoka Japan
  • Nobuo Shinohara
    Department of Urology Hokkaido University Sapporo Japan
  • Yoshihiko Tomita
    Department of Urology, Molecular Oncology Graduate School of Medical and Dental Sciences Niigata University Niigata Japan
  • Yukihiro Kondo
    Department of Urology Nippon Medical School Tokyo Japan
  • Kenya Ochi
    Ono Pharmaceutical Osaka Japan
  • Yoshio Anazawa
    Bristol‐Myers Squibb Tokyo Japan
  • Hirotsugu Uemura
    Department of Urology Kindai University Faculty of Medicine Osaka Japan

説明

<jats:sec><jats:title>Objectives</jats:title><jats:p>To clarify treatment patterns and outcomes for patients with unresectable or metastatic renal cell carcinoma in the molecular target therapy era in Japan.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A multicenter, retrospective medical chart review study was carried out. Patients diagnosed with unresectable or metastatic renal cell carcinoma between January 2012 and August 2015 were enrolled. Data extracted from medical records included treatment duration, grade ≥3 adverse events, reason for discontinuation for each targeted therapy and survival data until August 2016.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 277 eligible patients, 266, 170 and 77 received first‐, second‐ and third‐line systemic treatment, respectively. Tyrosine kinase inhibitors were the most common first‐line therapy (72.2%), followed by mammalian target of rapamycin inhibitors (14.3%) and cytokines (13.5%). Among 170 patients who received second‐line treatment, tyrosine kinase inhibitor–tyrosine kinase inhibitor was the most common sequence (58.8%), followed by tyrosine kinase inhibitor–mammalian target of rapamycin inhibitor (14.1%) and cytokine–tyrosine kinase inhibitor (14.1%). With a median follow‐up period of 19.8 months, median overall survival was not reached at 48 months. Patients who discontinued first‐line tyrosine kinase inhibitors in <6 months showed poorer overall survival compared with patients who received first‐line tyrosine kinase inhibitors for ≥6 months.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The present analysis illustrates the contemporary treatment patterns and prognosis for patients with unresectable or metastatic renal cancer in a real‐world setting in Japan. Tyrosine kinase inhibitor–tyrosine kinase inhibitor represents the most commonly used sequence. Shorter treatment duration of first‐line tyrosine kinase inhibitors is associated with poorer prognosis, suggesting the need for better treatment options.</jats:p></jats:sec>

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