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Bisphosphonates in patients with renal cell carcinoma and bone metastases: a sunitinib global expanded-access trial
Eduard Vrdoljak1, Martin Gore2, Sophie Leyman3
1Centre of Oncology, Medical School Split, University Hospital Split, Split, Spinciceva 1, 21000 Split, Croatia.
Aim:
To investigate retrospectively the effects of bone metastases and bisphosphonates in sunitinib-treated metastatic renal cell carcinoma patients.
Patients & Methods:
Patients in Groups (Gp) 1 and 2, but not Gp3, had bone metastases. Gp2 received bisphosphonates following standard practice.
Results:
Gp2 had less favorable prognosis than Gp1. Gp3 had fewer metastases and the best prognosis. More serious adverse events occurred in Gp2 versus Gp1. The difference in overall survival between Gp1 and Gp2 was not significant after adjusting for covariates. Significantly shorter overall survival in Gp1 versus Gp3 persisted after adjusting for covariates.
Conclusion:
Bone metastases may have a negative prognostic impact in metastatic renal cell carcinoma. Bisphosphonates may have delayed early disease progression for prognostically worse sunitinib/bisphosphonate-treated patients.
Insights
Bone metastases negatively impact prognosis in metastatic renal cell carcinoma patients treated with sunitinib. Bisphosphonates may delay progression in patients with a worse prognosis.
Area of Science:
- Oncology
- Pharmacology
Background:
- Metastatic renal cell carcinoma (mRCC) presents significant treatment challenges.
- Bone metastases are a common complication in mRCC, potentially influencing prognosis.
- Sunitinib is a standard targeted therapy for mRCC.
Purpose of the Study:
- To retrospectively analyze the impact of bone metastases on outcomes in sunitinib-treated mRCC patients.
- To evaluate the role of bisphosphonates in conjunction with sunitinib therapy.
Main Methods:
- Retrospective analysis of three patient groups with mRCC treated with sunitinib.
- Group 1: Sunitinib only, no bone metastases.
- Group 2: Sunitinib and bisphosphonates, with bone metastases.
- Group 3: Sunitinib only, with bone metastases (fewer than Gp2).
Main Results:
- Patients receiving bisphosphonates (Gp2) had a less favorable prognosis compared to those without bone metastases (Gp1).
- Group 3, with fewer metastases, demonstrated the best prognosis.
- More serious adverse events were observed in Gp2 versus Gp1.
- Overall survival did not significantly differ between Gp1 and Gp2 after covariate adjustment.
- Overall survival was significantly shorter in Gp1 compared to Gp3 after covariate adjustment.
Conclusions:
- Bone metastases appear to confer a negative prognostic impact in mRCC patients treated with sunitinib.
- Bisphosphonates might offer a delayed early disease progression benefit for sunitinib-treated patients with a poorer prognosis due to bone metastases.
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