晚期肾癌治疗进展.ppt

不同转移部位的预后存在差异 单纯肺转移（n=224） 其它（n=663） n=49 n=175 n=76 n=587 5年CSS：73.6% vs 19% 5年CSS：32.5% vs 12.4% Cancer 2011;117:2873-82. 转移灶切除程度的预后差异 n=257 n=505 n=125 中位CSS 5年CSS 4.8 49.4% 2.6 23.7% 1.1 8.9% Cancer 2011;117:2873-82. 多因素分析 Cancer 2011;117:2873-82. 小结 晚期肾癌靶向治疗的序贯治疗模式TKI-Mtor-TKI 非透明细胞癌的靶向治疗有效 目前尚缺乏指导治疗的BioMarker 新型免疫治疗药物已经出现，期待III期临床结果 应重视晚期肾癌的外科治疗 感 谢 聆 听 * First-line PFS: In the first-line treatment period, median PFS was 7.9 months for first-line EVE, versus 10.7 months for first-line SUN.1 Estimated first-line PFS hazard ratio (HR) was 1.43 (95% CI, 1.15–1.77), which did not satisfy the protocol-specified noninferiority margin. Therefore, this study did not meet the primary end point.1,2 References: Motzer RJ, Barrios CH, Kim TM, et al. RECORD-3: Phase II randomized trial comparing sequential first-line everolimus (EVE) and second-line sunitinib (SUN) versus first-line SUN and second-line EVE in patients with metastatic renal cell carcinoma (mRCC). Presented at American Society of Clinical Oncology (ASCO) Annual Meeting; May 31 – June 4, 2013; Chicago, Illinois (Abstract 4504). Data on file. Novartis Pharmaceuticals Corp, East Hanover, NJ. * * Combined PFS: Median PFS was 21.1 months for sequential EVE and SUN and 25.8 months for sequential SUN and EVE. The HREVE-SUN/SUN-EVE was 1.28 (95% CI, 0.94 – 1.73).1 NOTE: PFS-C was censored (at the last adequate tumor assessment) in 63% of randomized patients receiving the EVE – SUN sequence, and 66% of patients receiving the SUN – EVE sequence, jeopardizing the validity of the Kaplan-Meier estimates (medians) and HR.2 References: Motzer RJ, Barrios CH, Kim TM, et al. RECORD-3: Phase II randomized trial comparing sequential first-line everolimus (EVE) and second-line sunitinib (SUN) versus first-line SUN and second-line EVE in patients with metastatic renal cell carcinoma (mRCC). Presented at American Society of Clinical Oncology (ASCO) Annual Meeting; May 31 – June 4, 2013; Chicago, Illinois (Abstr