A high percentage of patients with metastatic renal cell carcinoma (mRCC) require a second-line option. We aimed to summarize available evidences about the clinicopathological profile of mRCC patients who receive a second-line therapy. A systematic review was performed in August 2020. We included papers that met the following criteria: original research; English language; human studies; enrolling mRCC patients entering a second-line therapy. Twenty-nine studies enrolling 7650 patients (73.5% male, mean age: 55 to 70 years) were included. Clear cell histology was reported in 74.4% to 100% of cases. Tyrosine kinase inhibitors, immunotherapy, bevacizumab, mTOR inhibitors, and chemotherapy were adopted as first line option in 68.5%, 29.2%, 2.9%, 0.6%, and 0.2% of patients, respectively. Discontinuation of first-line therapy was due to progression and toxicity in 18.4% to 100% and in 17% to 48.8% of patients, respectively. Eastern Cooperative Oncology Group performance status score was 0 or 1 in most cases. Most prevalent prognostic categories according to the International Metastatic RCC Database Consortium and Memorial Sloan-Kettering Cancer Centre score were intermediate and good. About 77.8% of patients harboured ≥2 metastatic sites. In conclusion, patients who enter a second-line therapy are heterogeneous in terms of a clinical-pathological profile. Tailoring of second-line treatment strategies is strongly advocated.
Cancers. 2020 Dec 04*** epublish ***
Nicola Longo, Marco Capece, Giuseppe Celentano, Roberto La Rocca, Gianluigi Califano, Claudia Collà Ruvolo, Carlo Buonerba, Fabio Esposito, Luigi Napolitano, Francesco Mangiapia, Ferdinando Fusco, Vincenzo Mirone, Massimiliano Creta
Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy., Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy., Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania 'Luigi Vanvitelli', 80131 Naples, Italy.