Bevacizumab Plus Erlotinib Combination Therapy for Advanced Hereditary Leiomyomatosis and Renal Cell Carcinoma-Associated Renal Cell Carcinoma: A Multicenter Retrospective Analysis in Korean Patients
- Author:
Yeonjoo CHOI
1
;
Bhumsuk KEAM
;
Miso KIM
;
Shinkyo YOON
;
Dalyong KIM
;
Jong Gwon CHOI
;
Ja Young SEO
;
Inkeun PARK
;
Jae Lyun LEE
Author Information
- Publication Type:Multicenter Study
- Keywords: Hereditary leiomyomatosis and renal cell carcinoma; Bevacizumab; Erlotinib; Renal cell carcinoma; Fumarate hydratase; Non-clear cell
- MeSH: Bevacizumab; Carcinoma, Renal Cell; Diagnosis; Disease-Free Survival; Erlotinib Hydrochloride; Fumarate Hydratase; Germ-Line Mutation; Hemorrhage; Humans; Leiomyomatosis; Retrospective Studies
- From:Cancer Research and Treatment 2019;51(4):1549-1556
- CountryRepublic of Korea
- Language:English
- 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 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). RESULT: 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.
