Target - Therapie
des
Nierenzell - Karzinoms
Allgemeines
Sunitinib
Sorafenib
Pazopanib
Kontrollen bei TKI
Bevacizumab
Lenvatinib, Kisplyx®
- fortgeschrittenes Nierenzellkarzinom
- in Kombination mit Everolimus
- nach VEGF-Therapie
Temsirolismus
| Studie | Target | Vergleich | Pat. | Indikation | PFS | OS |
| (2) | Sorafenib | Placebo | 903 | Second line nach Zytokinen, Risk 0-2 | 5.5 v 2.8 | 17.8 v 15.2 |
| (3) | Sunitinib | IF-α | 750 | First line, alle Risk-Gruppen | 11.0 v 5.0 | 26.4 v 21.8 |
| (4) | Temsirolimus | IF-α | 626 | First line, poor-risk group | 5.5 v 3.1 | 10.9 v 7.3 |
| AVOREN(5) | Bevacizumab +IF-α | IF-α | 649 | First line, alle Risk-Gruppen | 10.2 v 5.4 | ? |
| CALBG 90206 (6) | Bevacizumab + IF-α | IF-α | 732 | First line, alle Risk-Gruppen | 8.5 v 5.2 | ? |
| (7) | Everolimus | Placebo | 410 | Second line nach VEGF-IH, alle Risk-Gruppen | 4.0 v 1.9 | ? |
| Studie | Target | Vergleich | Pat. | Indikation | PFS | OS | |
| (9) | Axitinib 5 mg oral 2x/d | Sorafenib 400 mg oral 2x/d | 288 | 10,1M v 6,5M HR=0,767 p=,0377 | nicht reif | ||
| (10) | Tivozanib 1,5 mg/d oral , 3 W, 1 W Pause | Sorafenib 400 mg oral 2x/d | 517 | 11,9M v 9,1M HR=0,797 p=,042 | 29,3M v 28,8M HR=1,245, ns | Survival durch Crossover und Folgetherapien verfälscht | |
| (8) | Pazopanib 800 mg/d oral | Sunitinib 50 mg/d oral, 4 W, 2 W Pause off | 1,110 | 8,4M v 9,5M HR=1,05, ns | 28,4M v 29,3M HR=0,91, ns | Pazopanib noninferior zu Sunitinib bei geringeren Nebenwirkungen |
Glutaminase - IH
Journal of Clinical Oncology, 2006 ASCO Annual Meeting Proceedings Part I. Vol 24, No. 18S, 2006
2.) Escudier B, Eisen T, Stadler WM, et al.:
Sorafenib for treatment of renal cell carcinoma: Final efficacy and safety results of the phase III Treatment Approaches in Renal Cancer Global Evaluation Trial.
J Clin Oncol 27(2009):3312–3318
3.) Motzer RJ, Hutson TE, Tomczak P, et al.:
Sunitinib versus interferon alfa in metastatic renal-cell carcinoma.
N Engl J Med 356(2007):115–124.
4.) Hudes G, Carducci M, Tomczak P, et al.:
Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma.
N Engl J Med 356(2007):2271–2281.
5.) Escudier B, Pluzanska A, Koralewski P, et al.:
Bevacizumab plus interferon alfa-2a for treatment of metastatic renal-cell carcinoma: A randomised, double-blind phase III trial.
Lancet 370(2007):2103–2111.
6.) Rini BI, Halabi S, Rosenberg JE, et al.:
Bevacizumab plus interferon alfa compared with interferon alfa monotherapy in patients with metastatic renal cell carcinoma: CALGB 90206.
J Clin Oncol 26(2008):5422–5428.
7.) Motzer RJ, Escudier B, Oudard S, et al.:
Efficacy of everolimus in advanced renal cell carcinoma: A double-blind, randomised, placebo-controlled phase III trial.
Lancet 372(2008):449–456.
8.) Motzer RJ, et al.:
Pazopanib versus Sunitinib in Metastatic Renal-Cell Carcinoma.
N Engl J Med 369(2013):722-31. DOI: 10.1056/NEJMoa1303989
9.) Hutson TE, Gallardo J, Lesovoy V, et al:
Axitinib versus sorafenib as first-line therapy in patients with metastatic renal cell carcinoma (mRCC).
J Clin Oncol 31, 2013 (suppl 6s; abstr LBA348)
10.) Motzer RJ, Nosov D, Eisen T, et al:
Tivozanib versus sorafenib as initial targeted therapy for patients with metastatic renal cell carcinoma: Results from a phase III trial.
J Clin Oncol 31(2013):3791-3799
