Outcome of oligoprogressing metastatic renal cell carcinoma patients treated with locoregional therapy: a multicenter retrospective analysis

// Daniele Santini 1 , Raffaele Ratta 2 , Francesco Pantano 1 , Delia De Lisi 1 , Marco Maruzzo 3 , Luca Galli 4,6 , Elisa Biasco 4 , Azzurra Farnesi 4 , Sebastiano Buti 5 , Cora Nanette Sternberg 6 , Linda Cerbone 6 , Giuseppe Di Lorenzo 7 , Silvia Spoto 8 , Michelle Sterpi 1 , Ugo De Giorgi 9 , Rossana Berardi 10 , Mariangela Torniai 10 , Andrea Camerini 11 , Francesco Massari 12 , Giuseppe Procopio 2 and Giuseppe Tonini 1 1 Campus Bio-Medico University of Rome, Department of Medical Oncology, Rome, Italy 2 Fondazione IRCCS, Istituto Nazionale dei Tumori, Oncology Unit 1, Milan, Italy 3 Istituto Oncologico Veneto, IOV-IRCCS, Medical Oncology 1 Unit, Padova, Italy 4 University Hospital of Pisa, Oncology Unit 2, Pisa, Italy 5 University Hospital of Parma, Medical Oncology, Parma, Italy 6 San Camillo and Forlanini Hospitals, Department of Medical Oncology, Rome, Italy 7 Department of Clinical Medicine & Surgery, Oncology Division, University Federico II, Naples, Italy 8 Campus Bio-Medico University of Rome, Department of Internal Medicine, Rome, Italy 9 IRCCS Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori, Department of Medical Oncology, Meldola, Italy 10 Universita Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Medical Oncology Unit, Ancona, Italy 11 Versilia Hospital and Istituto Toscano Tumori, Medical Oncology, Lido di Camaiore, Italy 12 S.Orsola-Malpighi Hospital, Division of Oncology, Bologna, Italy Correspondence to: Delia De Lisi, email: // Keywords : metastatic renal cell carcinoma (mRCC), oligoprogression, pazopanib, sunitinib, targeted therapy Received : April 25, 2016 Accepted : June 19, 2017 Published : August 07, 2017 Abstract Locoregional treatment with radical intent should be considered during therapy with targeted agents in patients with metastatic renal cell carcinoma (mRCC) in order to achieve a complete response, especially in the setting of an oligo-progression in one or more metastatic sites. We retrospectively enrolled 55 patients who experienced a disease oligo-progression after at least 6 months from the beginning of first-line therapy in one or more metastatic sites radically treated with locoregional treatments. Post-first-oligo-progression overall survival (PFOPOS) and post-first-oligo-progression free survival (PFOPFS) were evaluated. The global median PFOPOS and PFOPFS were 37 months and 14 months respectively. Patients who continued the same therapy after a locoregional treatment on a site of progression had a significantly longer mPFOPOS compared to patients who changed therapy (39 vs 11 months, p =0.014). An advantage in mPFOPOS was also observed in patients with a Memorial Sloan-Kettering Cancer Center (MSKCC) good risk score compared to patients of the intermediate risk group (39 vs 29 months, p =0.036); patients with bone metastases had a longer mPFOPOS compared to those with visceral metastases (not reached vs 31 months, p =0.045). The only independent predictor of poor prognosis, in terms of PFOPOS at multivariate analysis ( p =0.007), proved out to be change of treatment after first progression. In this paper we aim to illustrate that continuing the same systemic therapy, after a radical locoregional treatment on a site of progression, seems to be associated with a prolongation of mPFOPOS.