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Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC)

BACKGROUND: Systemic therapy (ST) can be deferred in patients who have metastatic renal cell carcinoma (mRCC) and slow‐growing metastases. Currently, this subset of patients managed with active surveillance (AS) is not well described in the literature. METHODS: This was a prospective observational s...

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Autores principales: Harrison, Michael R., Costello, Brian A., Bhavsar, Nrupen A., Vaishampayan, Ulka, Pal, Sumanta K., Zakharia, Yousef, Jim, Heather S. L., Fishman, Mayer N., Molina, Ana M., Kyriakopoulos, Christos E., Tsao, Che‐Kai, Appleman, Leonard J., Gartrell, Benjamin A., Hussain, Arif, Stadler, Walter M., Agarwal, Neeraj, Pachynski, Russell K., Hutson, Thomas E., Hammers, Hans J., Ryan, Christopher W., Inman, Brant A., Mardekian, Jack, Borham, Azah, George, Daniel J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251950/
https://www.ncbi.nlm.nih.gov/pubmed/33765337
http://dx.doi.org/10.1002/cncr.33494
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author Harrison, Michael R.
Costello, Brian A.
Bhavsar, Nrupen A.
Vaishampayan, Ulka
Pal, Sumanta K.
Zakharia, Yousef
Jim, Heather S. L.
Fishman, Mayer N.
Molina, Ana M.
Kyriakopoulos, Christos E.
Tsao, Che‐Kai
Appleman, Leonard J.
Gartrell, Benjamin A.
Hussain, Arif
Stadler, Walter M.
Agarwal, Neeraj
Pachynski, Russell K.
Hutson, Thomas E.
Hammers, Hans J.
Ryan, Christopher W.
Inman, Brant A.
Mardekian, Jack
Borham, Azah
George, Daniel J.
author_facet Harrison, Michael R.
Costello, Brian A.
Bhavsar, Nrupen A.
Vaishampayan, Ulka
Pal, Sumanta K.
Zakharia, Yousef
Jim, Heather S. L.
Fishman, Mayer N.
Molina, Ana M.
Kyriakopoulos, Christos E.
Tsao, Che‐Kai
Appleman, Leonard J.
Gartrell, Benjamin A.
Hussain, Arif
Stadler, Walter M.
Agarwal, Neeraj
Pachynski, Russell K.
Hutson, Thomas E.
Hammers, Hans J.
Ryan, Christopher W.
Inman, Brant A.
Mardekian, Jack
Borham, Azah
George, Daniel J.
author_sort Harrison, Michael R.
collection PubMed
description BACKGROUND: Systemic therapy (ST) can be deferred in patients who have metastatic renal cell carcinoma (mRCC) and slow‐growing metastases. Currently, this subset of patients managed with active surveillance (AS) is not well described in the literature. METHODS: This was a prospective observational study of patients with mRCC across 46 US community and academic centers. The objective was to describe baseline characteristics and demographics of patients with mRCC initially managed by AS, reasons for AS, and patient outcomes. Descriptive statistics were used to characterize demographics, baseline characteristics, and patient‐related outcomes. Wilcoxon 2‐sample rank‐sum tests and χ(2) tests were used to assess differences between ST and AS cohorts in continuous and categorical variables, respectively. Kaplan‐Meier survival curves were used to assess survival. RESULTS: Of 504 patients, mRCC was initially managed by AS (n = 143) or ST (n = 305); 56 patients were excluded from the analysis. Disease was present in 69% of patients who received AS, whereas the remaining 31% had no evidence of disease. At data cutoff, 72 of 143 patients (50%) in the AS cohort had not received ST. The median overall survival was not reached (95% CI, 122 months to not estimable) in patients who received AS versus 30 months (95% CI, 25‐44 months) in those who received ST. Quality of life at baseline was significantly better in patients who were managed with AS versus ST. CONCLUSIONS: AS occurs frequently (32%) in real‐world clinical practice and appears to be a safe and appropriate alternative to immediate ST in selected patients.
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spelling pubmed-82519502021-07-07 Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC) Harrison, Michael R. Costello, Brian A. Bhavsar, Nrupen A. Vaishampayan, Ulka Pal, Sumanta K. Zakharia, Yousef Jim, Heather S. L. Fishman, Mayer N. Molina, Ana M. Kyriakopoulos, Christos E. Tsao, Che‐Kai Appleman, Leonard J. Gartrell, Benjamin A. Hussain, Arif Stadler, Walter M. Agarwal, Neeraj Pachynski, Russell K. Hutson, Thomas E. Hammers, Hans J. Ryan, Christopher W. Inman, Brant A. Mardekian, Jack Borham, Azah George, Daniel J. Cancer Original Articles BACKGROUND: Systemic therapy (ST) can be deferred in patients who have metastatic renal cell carcinoma (mRCC) and slow‐growing metastases. Currently, this subset of patients managed with active surveillance (AS) is not well described in the literature. METHODS: This was a prospective observational study of patients with mRCC across 46 US community and academic centers. The objective was to describe baseline characteristics and demographics of patients with mRCC initially managed by AS, reasons for AS, and patient outcomes. Descriptive statistics were used to characterize demographics, baseline characteristics, and patient‐related outcomes. Wilcoxon 2‐sample rank‐sum tests and χ(2) tests were used to assess differences between ST and AS cohorts in continuous and categorical variables, respectively. Kaplan‐Meier survival curves were used to assess survival. RESULTS: Of 504 patients, mRCC was initially managed by AS (n = 143) or ST (n = 305); 56 patients were excluded from the analysis. Disease was present in 69% of patients who received AS, whereas the remaining 31% had no evidence of disease. At data cutoff, 72 of 143 patients (50%) in the AS cohort had not received ST. The median overall survival was not reached (95% CI, 122 months to not estimable) in patients who received AS versus 30 months (95% CI, 25‐44 months) in those who received ST. Quality of life at baseline was significantly better in patients who were managed with AS versus ST. CONCLUSIONS: AS occurs frequently (32%) in real‐world clinical practice and appears to be a safe and appropriate alternative to immediate ST in selected patients. John Wiley and Sons Inc. 2021-03-25 2021-07-01 /pmc/articles/PMC8251950/ /pubmed/33765337 http://dx.doi.org/10.1002/cncr.33494 Text en © 2021 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Harrison, Michael R.
Costello, Brian A.
Bhavsar, Nrupen A.
Vaishampayan, Ulka
Pal, Sumanta K.
Zakharia, Yousef
Jim, Heather S. L.
Fishman, Mayer N.
Molina, Ana M.
Kyriakopoulos, Christos E.
Tsao, Che‐Kai
Appleman, Leonard J.
Gartrell, Benjamin A.
Hussain, Arif
Stadler, Walter M.
Agarwal, Neeraj
Pachynski, Russell K.
Hutson, Thomas E.
Hammers, Hans J.
Ryan, Christopher W.
Inman, Brant A.
Mardekian, Jack
Borham, Azah
George, Daniel J.
Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC)
title Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC)
title_full Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC)
title_fullStr Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC)
title_full_unstemmed Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC)
title_short Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC)
title_sort active surveillance of metastatic renal cell carcinoma: results from a prospective observational study (marcc)
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251950/
https://www.ncbi.nlm.nih.gov/pubmed/33765337
http://dx.doi.org/10.1002/cncr.33494
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