Treatment holidays for patients with metastatic kidney cancer

Targeted therapy is the standard treatment of patients with metastatic cancer of the kidney. The best current therapies target the tumour vasculature thereby blocking the access of the tumour to nutrients and limiting possibility of spreading to distant parts of the body.

Fig. 1. Probability of relapse was similar in patients who coninued therapy and those who did not after reaching complete response.

Fig. 1. Probability of relapse was similar in patients who coninued therapy and those who did not after reaching complete response.

Kidney cancer that has already spread and formed metastases is considered incurable. However, a minor part of patients will have excellent response to targeted therapies and will experience complete response – disappearance of all tumour lesions. We believe that this does not, unfortunately, mean cure because the tumour will come back (relapse) in almost all of them after certain time. Nevertheless, interruption of treatment may be possible and is often done in these patients to enable them a period of rest from side effects of therapy.

According to this registry-based analysis, patients with metastatic renal cancer with no signs of disease (complete response) after treatment with targeted agents experience excellent long-term survival even if the treatment does not continue beyond the date of complete response.

Of 2803 patients with data on targeted therapy in our national registry, 100 patients achieved complete response. These patients experienced excellent survival and 80% were still alive 5 years after the start of therapy. This is much better than average patients treated for metastatic kidney cancer. Importantly, if the treatment was discontinued while the patients were still in complete response, the survival was not adversely affected.  This is a retrospective study with some limitations but the results are encouraging for those patients who have complete response and want to spend some time off treatment, and their physicians.

Tomas Buchler
Department of Oncology, First Faculty of Medicine
Charles University and Thomayer Hospital
Prague, Czech Republic

 

Publication

Outcomes for Patients with Metastatic Renal Cell Carcinoma Achieving a Complete Response on Targeted Therapy: A Registry-based Analysis.
Buchler T, Bortlicek Z, Poprach A, Pavlik T, Veskrnova V, Honzirkova M, Zemanova M, Fiala O, Kubackova K, Slaby O, Svoboda M, Vyzula R, Dusek L, Melichar B; Czech Renal Cancer Cooperative Group.
Eur Urol. 2015 Dec 30

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