[Metastatic renal cell carcinoma treated with everolimus--data from the RENIS Clinical Registry]

T Büchler1, L Dusek, J Fínek

  • 1Onkologické oddelení, Fakultní Thomayerova nemocnice a 1. lékarska fakulta Univerzity Karlovy, Praha. tomas.buchler@ftn.cz

Insights

Everolimus offers clinical benefit for metastatic renal cell carcinoma (mRCC) patients who have not responded to vascular endothelial growth factor (VEGF)-targeted therapy. This study found a median progression-free survival of 7 months with manageable toxicity in heavily pretreated patients.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Metastatic renal cell carcinoma (mRCC) is a complex cancer.
  • Vascular endothelial growth factor (VEGF)-targeted agents are a common treatment.
  • Resistance to VEGF-targeted therapy necessitates alternative treatment options.

Purpose of the Study:

  • To evaluate the efficacy and safety of everolimus in patients with mRCC.
  • To analyze outcomes in patients previously treated with VEGF-targeted agents.

Main Methods:

  • Retrospective analysis of patients from the RENIS clinical registry.
  • Inclusion of 78 evaluable patients with mRCC treated with everolimus.
  • Assessment of progression-free survival, response rates, and adverse events.

Main Results:

  • Median progression-free survival was 7 months (95% CI: 2-12 months).
  • 69% of patients achieved partial response or stable disease.
  • Serious adverse events occurred in 6% of patients, primarily respiratory toxicity.

Conclusions:

  • Everolimus demonstrates significant clinical benefit in heavily pretreated mRCC patients.
  • The therapy is effective after failure of VEGF-targeted treatments.
  • Everolimus offers a valuable treatment option with predictable and manageable toxicity.

Related Concept Videos

Treatment Resistent Cancers02:56

Treatment Resistent Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Renal Drug Excretion: Tubular Reabsorption01:25

Renal Drug Excretion: Tubular Reabsorption

Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...
Renal Drug Excretion: Overview01:15

Renal Drug Excretion: Overview

As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules out...
Renal Drug Clearance: Overview01:06

Renal Drug Clearance: Overview

Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Renal Drug Excretion: Tubular Secretion01:28

Renal Drug Excretion: Tubular Secretion

Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...