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Metastatic renal cancer: evolution of five complete response cases after the antiangiogenic discontinuation
Julien Demiselle1, Stéphanie Lheureux, Bénédicte Clarisse
1CLCC François-Baclesse, service de recherche clinique, avenue du Général-Harris, 14000 Caen, FranceCLCC François-Baclesse, service de recherche clinique, avenue du Général-Harris, 14000 Caen, France.
Abstract:
Antiangiogenic therapies have led to substantial progress in the management of kidney cancer, highly vascular tumor, and chemoresistant. These molecules have improved the prognosis of metastatic renal cancer. However, only a few isolated cases of complete response have been described and the evolution of these patients after treatment discontinuation remains unclear. From a series of patients treated for kidney cancer with antiangiogenic in first line, the purpose of this study was to identify patients in complete response in whom treatment had been interrupted. Complete response was defined according to RECIST criteria and data were collected retrospectively at the Centre François Baclesse - Caen. Five patients were identified in complete response with a treatment discontinuation among sixty-seven patients. These five patients of good or intermediate prognosis received an initial nephrectomy followed by a first-line treatment by Sunitinib (ten cycles on average). After one year of stopping treatment, two patients are still in complete response and three patients relapsed at three, 12 and 15 months. The treatment of relapsing disease was surgical followed by monitoring or resumption of sunitinib resulting in new complete response for the all three patients. The interruption of antiangiogenic treatment seems acceptable after a complete response.
Insights
Antiangiogenic therapies offer improved outcomes for kidney cancer patients. Discontinuing treatment after complete response may be acceptable, though relapse can occur and be effectively re-treated.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Antiangiogenic therapies have significantly advanced kidney cancer management, particularly for metastatic and chemoresistant disease.
- While these treatments improve prognosis, complete response and post-treatment evolution remain incompletely understood.
Purpose of the Study:
- To identify patients with kidney cancer who achieved complete response to first-line antiangiogenic therapy and subsequently discontinued treatment.
- To evaluate the outcomes and disease progression in patients after stopping antiangiogenic therapy following complete response.
Main Methods:
- Retrospective analysis of patients treated with first-line antiangiogenic therapy at Centre François Baclesse.
- Identification of patients achieving complete response (per RECIST criteria) and subsequently discontinuing treatment.
- Data collection on patient prognosis, treatment details (Sunitinib), and follow-up duration.
Main Results:
- Five out of sixty-seven patients achieved complete response and discontinued antiangiogenic treatment (Sunitinib).
- Two patients maintained complete response one year after stopping treatment; three relapsed at 3, 12, and 15 months.
- Relapsed disease was managed with surgery and/or Sunitinib resumption, leading to new complete responses in all three patients.
Conclusions:
- Interruption of antiangiogenic therapy appears feasible and potentially acceptable for kidney cancer patients achieving complete response.
- Relapse after treatment discontinuation is possible but manageable with subsequent interventions, including Sunitinib re-challenge.
- Further investigation into optimal antiangiogenic treatment duration and discontinuation strategies is warranted.
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