Everolimus in every day practice of metastatic renal cell carcinoma therapy – one center experience

Introduction: Everolimus is a selective mTOR inhibitor which received approval for treatment of advanced renal cell carcinoma (mRCC) after progression on or after treatment with VEGF-targeted therapy. The aim of this study was to evaluate the efficiency and toxicity profile of everolimus in second line therapy of mRCC. The authors also assessed the impact of clinicopathological factors on the effectiveness of everolimus. Methods: The retrospective analysis was conducted on the medical records of 33 mRCC patients who were treated with everolimus in second line therapy after progression on interferon or tyrosine kinase inhibitors (sunitinib or pazopanib) during the years 2010–2016. Results: Median time of treatment with everolimus was 4 months (range from 1 to 58 months). Median progression free survival was 4 months and overall survival (OS) was 11 months. The best response (PR + CR + SD) was reported in 57% of patients. Toxicity in grade 3–4 was reported in 9 (27%) of patients. Clinicopathological factors associated with progression during everolimus therapy were: smoking and alcohol abuse (p = 0.029), higher Furman grade (p = 0.166), tumor necrosis (p = 0.383), fat tissue infiltration (p = 0.040), lymph node (p = 0.193) and adrenal metastases (p = 0.067). Factors which increase the risk of everolimus toxicity were worse performance status (p = 0.333) and more advanced disease at the beginning (lymph nodes metastases, p = 0.05) and higher Furman grade (p = 0.04). Conclusions: Cigarettes use and/or alcohol abuse, adrenal metastases, fat tissue had significantly negative influence on survival. Grade 3–4 toxicity were reported more frequently in patients with worse performance status and more advanced disease at the time of diagnosis.