The median progression-free survival (PFS) was 2.4 months (range 1-4.6 months). In 22/35 patients, progressive disease was associated with new metastatic lesions. Subsequent therapy included other TKI or mTOR-inhibitors in 25/32 patients. The associated median PFS was 3.2 months (range 1-6.6 months). The type of subsequent therapy (TKI versus mTOR inhibitor) had no impact on outcome. Median overall survival of the study group was 14.9 months (range 5.5-24.4 months). The authors concluded that outcome of patients with intrinsic resistance to TKI is poor.
This trial demonstrates that clinically defined resistance – i.e. short PFS - is associated with short PFS in subsequent therapy lines as well as short overall survival. The pathways behind are poorly understood and clearly predictive biomarkers are needed to trigger the best possible therapy in these patients. These biomarker trials are underway but it has been learned in the past 5 years that correlation of soluble and/or tissue markers to efficacy is difficult to demonstrate.
Presented by J. Busch et al. at the Deutsche Gesellschaft für Urologie (DGU) - 63rd Annual Congress - September 14 - 17, 2011 - Congress Center - Hamburg, Germany
Reported for UroToday by Christian Doehn, MD, PhD, Urologikum Lubeck, Lubeck, Germany.
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