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.
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.
Department of Oncology, First Faculty of Medicine
Charles University and Thomayer Hospital
Prague, Czech Republic
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
|Too hard to defeat Devils Hematopoietic cell transplantation (HCT) offers potentially curative therapy for patients with myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML). However, relapse following HCT is considerable and becomes a major cause of…|
|When the immune system is away, biliary cancer cells… Tumours of the biliary tract (BTC) develop from the epithelium of bile ducts located inside and outside the liver and in the gallbladder. Surgery is the only curative treatment available.…|
|Celiac disease and liver disorders Immunologically mediated liver diseases belong to the common extraintestinal manifestations of celiac disease. In celiac disease, increased intestinal permeability is thought to be an early feature in the pathogenesis. Dietary…|
|Percutaneous axillary artery access for fenestrated… An upper extremity access (UEA) is necessary for complex endovascular aortic repairs, especially for branched and fenestrated endografts to successfully catheterize target vessels with a caudal orientation. The subclavian artery…|
|Pancreatic incidentalomas: is laparoscopic approach… Pancreatic incidentaloma is an asymptomatic incidentally lesion detected on a radiologic imaging performed for unrelated indication. This definition has been proposed for adrenal mass but actually the term is used…|
|Prolonged survival with quality of life can come… Currently, pazopanib is used as a second- or third-line adjuvant chemotherapeutic in patients with soft tissue sarcoma, given at a fixed dose of 800 mg once a day. However, pazopanib…|