Bevacizumab Plus Erlotinib Combination Therapy for Advanced Hereditary Leiomyomatosis and Renal Cell Carcinoma-Associated Renal Cell Carcinoma: A Multicenter Retrospective Analysis in Korean Patients
- Authors
- Choi, Yeonjoo; Keam, Bhumsuk; Kim, Miso; Yoon, Shinkyo; Kim, Dalyong; Choi, Jong Gwon; Seo, Ja Young; Park, Inkeun; Lee, Jae Lyun
- Issue Date
- Oct-2019
- Publisher
- KOREAN CANCER ASSOCIATION
- Keywords
- Hereditary leiomyomatosis and renal cell carcinoma; Bevacizumab; Erlotinib; Renal cell carcinoma; Fumarate hydratase; Non-clear cell
- Citation
- CANCER RESEARCH AND TREATMENT, v.51, no.4, pp.1549 - 1556
- Journal Title
- CANCER RESEARCH AND TREATMENT
- Volume
- 51
- Number
- 4
- Start Page
- 1549
- End Page
- 1556
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/967
- DOI
- 10.4143/crt.2019.086
- ISSN
- 1598-2998
- Abstract
- Purpose Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is a rare genetic syndrome resulting from germline mutations in fumarate hydratase. The combination of bevacizumab plus erlotinib showed promising interim results for HLRCC-associated renal cell carcinoma (RCC). Based on these results, we analyzed the outcome of bevacizumab plus erlotinib in Korean patients with HLRCC-associated RCC. Materials and Methods We retrospectively reviewed the efficacy and safety of bevacizumab plus erlotinib in patients with HLRCC-associated RCC who were confirmed to have germline mutations in fumarate hydratase. The primary endpoint was the objective response rate (ORR), while the secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results We identified 10 patients with advanced HLRCC-associated RCC who received bevacizumab plus erlotinib. Median age at diagnosis was 41 years, and five of the patients had received the combination as first- or second-line treatments. The ORR was 50% and the median PFS and OS were 13.3 and 14.1 months, respectively. Most adverse events were predictable and manageable by conventional measures, except for one instance where a patient died of gastrointestinal bleeding. Conclusion This is the first real-world outcome of the treatment of advanced HLRCC-associated RCC. Bevacizumab plus erlotinib therapy showed promising activity with moderate toxicity. We should be increasingly aware of HLRCC-associated RCC and bevacizumab plus erlotinib should be a first-line treatment for this condition, unless other promising data are published.
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