Conditional survival of patients with metastatic renal-cell carcinoma treated with VEGF-targeted therapy: a population-based study

摘要: Summary Background The advent of targeted therapies in the past 7 years has extended median survival for metastatic renal-cell carcinoma. This improvement clinical outcome created a need new, more accurate prognostic measures. We assessed use conditional survival—a measure that accounts elapsed time since treatment initiation—for prognostication patients with carcinoma treated first-line VEGF-targeted therapies. Methods obtained data who were therapy between April 7, 2003, and Oct 12, 2010, from our large multi-institutional International mRCC Database Consortium (centres Canada, USA, Singapore, Denmark, South Korea). All histologies, performance statuses, risk groups included. primary was 2-year survival, defined as probability surviving an additional 2 given timepoint start therapy. Secondary analyses included 1-year 3-year along stratification by Heng criteria Karnofsky score, based on length used Kaplan-Meier method landmark analysis to calculate survival. Findings In 1673 analysed, follow-up alive 20·1 months (IQR 9·0–34·4). recorded increase 44% (95% CI 41–47) at 0 51% (46–55) 18 beginning When stratified initiation, changed little favourable intermediate groups, but poor-risk group, improved 11% (8–15) 33% (18–48) after months. conditioned months, (41–47) 68% (60–75) overall population 74% (68–79) 90% (77–96) 49% (45–53) 57% (45–67) 73% (43–89) poor group. Interpretation Conditional is clinically useful prediction adjusts prognosis basis initiation or duration. might be especially relevant adjust patients. Funding Trust Family Fund Kidney Cancer Research.