Korean J Urol.  2015 Mar;56(3):205-211. 10.4111/kju.2015.56.3.205.

Interferon treatment for Japanese patients with favorable-risk metastatic renal cell carcinoma in the era of targeted therapy

• Sazuka T
• Nihei N
• Nakamura K
• Sakamoto S
• Fukasawa S
• Komaru A
• Ueda T
• Igarashi T
• Ichikawa T

• KMID: 2133288
• DOI: http://doi.org/10.4111/kju.2015.56.3.205

Abstract

PURPOSE
Single-agent interferon (IFN) is no longer regarded as a standard option for first-line systemic treatment of metastatic renal cell carcinoma (RCC) in Western countries. However, some patients with favorable-risk RCC may still achieve complete and long-lasting remission in response to IFN treatment. The present study compared favorable-risk Japanese patients with metastatic RCC Japanese patients who had been treated with IFN or tyrosine kinase inhibitor (TKI) therapy as a first-line systemic therapy.
MATERIALS AND METHODS
From 1995 to 2014, a total of 48 patients with favorable risk as defined by the Memorial Sloan Kettering Cancer Center criteria who did not receive adjuvant systemic therapy were retrospectively enrolled in this study. We assessed the tumor response rate, progression-free survival (PFS), and overall survival (OS).
RESULTS
The objective response rate for first-line therapy was 29% in the IFN group and 47% in the TKI group, but this difference did not reach the level of statistical significance. Median OS for IFN and TKI was 71 and 47 months, respectively (p=0.014). Median first-line PFS for IFN and TKI was 20 and 16 months, respectively (no significant difference). First-line IFN therapy did not prove inferior to TKI therapy in terms of OS according to metastatic sites.
CONCLUSIONS
IFN is associated with a survival benefit in Japanese patients with favorable-risk metastatic RCC in the era of targeted therapy. Further prospective study is needed.

Keyword

Interferons; Protein-tyrosine kinases; Renal cell carcinoma

MeSH Terms

Adult
Aged
Antineoplastic Agents/*therapeutic use
Carcinoma, Renal Cell/*drug therapy
Disease-Free Survival
Female
Humans
Interferons/*therapeutic use
Japan
Kidney Neoplasms/*drug therapy
Male
Middle Aged
Neoplasm Metastasis/drug therapy
Protein Kinase Inhibitors/therapeutic use
Protein-Tyrosine Kinases/antagonists & inhibitors
Retrospective Studies
Risk Factors
Treatment Outcome
Antineoplastic Agents
Interferons
Protein Kinase Inhibitors
Protein-Tyrosine Kinases

Figure

• 

  Fig. 1 Response rate to first-line therapy: interferon (IFN) (n=31), tyrosine kinase inhibitor (TKI) (n=17). CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.

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  Fig. 2 (A) Kaplan-Meier curves of overall survival (p=0.014) and (B) progression-free survival (p=0.302) in patients who received interferon (IFN) or tyrosine kinase inhibitor (TKI) as first-line therapy for metastatic renal cell cancer. Solid line represents IFN and dotted line represents TKI.

• 

  Fig. 3 Kaplan-Meier curves of second-line progression-free survival according to first-line therapy (p=0.380). Solid line represents first-line Interferon (IFN) and dotted line represents first-line tyrosine kinase inhibitor (TKI).

• 

  Fig. 4 (A) Kaplan-Meier curves of overall survival in patients with lung and/or lymph nodes metastasis (p=0.230) and (B) in patients with metastatic disease at sites other than the lung or lymph nodes (p=0.032). Solid line represents Interferon (IFN) and dotted line represents tyrosine kinase inhibitor (TKI).

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