Prognostic factors for survival following initiation of second-line treatment with everolimus for metastatic renal cell carcinoma: evidence from a nationwide sample of clinical practice in the United States.

Journal Article (Journal Article)

OBJECTIVE: Comparing prognostic factors for overall survival (OS) in community-practice metastatic renal cell carcinoma (mRCC) patients receiving second-line everolimus with those previously reported in clinical trials. RESEARCH DESIGN AND METHODS: Two separate chart sets (2009 - 2012) were used to develop and validate a prognostic model for patients initiating second-line everolimus after first-line tyrosine kinase inhibitor (TKI). MAIN OUTCOME MEASURES: Prognostic factors for OS have been identified and validated in separate samples. RESULTS: One-year OS probabilities in the study (n = 220) and validation (n = 97) samples were 68 and 67%; median OS was 19 and 23 months - higher than the 1-year OS of 60% and median OS of 14.8 months of RECORD-1. Karnofsky performance score < 80%, duration of mRCC < 1 year, progression on first-line TKI, liver metastasis and clear cell histology were significant prognostic factors for shorter survival. One-year OS estimates were 84% for validation sample patients with 0 - 2 risk factors, 63% for 3 risk factors and 22% for 4 - 5 risk factors (log-rank p < 0.001). CONCLUSION: Real-world prognostic factors for OS following second-line everolimus for mRCC were largely consistent with those previously identified in trial data; however, OS was longer in the practice setting than in clinical trials and was not associated with type of first-line TKI.

Full Text

Duke Authors

Cited Authors

  • Wong, MK; Jonasch, E; Pal, SK; Signorovitch, JE; Lin, PL; Wang, X; Liu, Z; Culver, K; Scott, JA; George, DJ; Vogelzang, NJ

Published Date

  • April 2015

Published In

Volume / Issue

  • 16 / 6

Start / End Page

  • 805 - 819

PubMed ID

  • 25766864

Electronic International Standard Serial Number (EISSN)

  • 1744-7666

Digital Object Identifier (DOI)

  • 10.1517/14656566.2015.1020298


  • eng

Conference Location

  • England