Effect of Metformin on RCC Survival Warrants Further Study

Editor’s note: This article is about a research study that looked at the effects of taking the anti-diabetes drug metformin before surgery for renal cell carcinoma (RCC). The researchers found that metformin might improve patients’ survival times. However, more research is needed to see whether metformin is truly beneficial.

“Patient exposure to metformin before undergoing nephrectomy for renal cell carcinoma (RCC) may have an effect on patient survival, according to the results of a study published recently in Urologic Oncology.

“Results of the study showed a positive effect of the anti-diabetes drug in an unadjusted analysis; however, this effect was not seen on multivariable analysis.

“ ‘Interest in metformin as a possible therapeutic option for RCC has been generated by emerging data from both observation and prospective studies assessing the association between risk of cancer-related death and exposure to metformin for a variety of malignancies,’ wrote Sarah P. Psutka, MD, of the department of urology at Mayo Clinic, Rochester, Minn., and colleagues.”


OncoBriefs: Local Tx for mRCC, Cervical Ca Prevention (CME/CE)

Editor’s note: This article describes three separate new findings in cancer research. The first is relevant for people with metastatic renal cell carcinoma (mRCC). Researchers have found that image-guided local ablation of tumors still has an important treatment role, even though there have been recent improvements in mRCC drugs. The second finding concerns people with metastatic neuroendocrine tumors (NETS). A clinical trial with volunteer patients found promising results for patients treated with the new drug lanreotide (aka Somatuline). The third finding has to do with preventing cervical cancer in women at high risk for the disease. The women involved in the study had high-grade cervical intraepithelial neoplasia (CIN 2/3), and were treated with surgical removal of the squamocolumnar junction (SCJ). These women had only low-grade recurrences, suggesting that removing SCJ cells might help prevent cervical cancer.

“More than 80% of patients with metastatic renal cell carcinoma (mRCC) remained alive without disease progression 3 years after image-guided local ablation of tumors, a retrospective study showed.

“Six of 76 evaluable tumors recurred an average of 1.6 years from treatment. Local ablation represents a “relatively safe procedure with acceptable local control rates,” authors concluded in an article published in the August issue of the Journal of Urology. A summary of the article leads off this edition of OncoBriefs, which also examines a somatostatin derivative for neurendocrine tumors and a surgical approach to cervical cancer prevention.”


Sunitinib or Everolimus First-Line for Kidney Cancer?

Editor’s note: Researchers conducted a clinical trial with volunteer patients to compare two drugs for kidney cancer: everolimus (aka Afinitor) and sunitinib (aka Sutent). The results showed that sunitinib is more effective as a first-line treatment for people diagnosed with metastatic renal cell carcinoma (mRCC). The standard treatment already widely prescribed to mRCC patients is sunitinib or a similar drug, followed by everolimus if the disease worsens. Oncologists wondered if everolimus could be a first-line therapy for mRCC, but it appears that the current standard is the better choice.

“Everolimus (Afinitor, Novartis) is not as effective as sunitinib (Sutent, Pfizer) in the first-line setting for patients with metastatic renal cell carcinoma, and it has a different toxicity profile, according to a phase 2 randomized direct comparator trial.

“The study, known as RECORD-3, was published online July 21 in the Journal of Clinical Oncology.

” ‘The hope was that everolimus would be better tolerated and as good as sunitinib in first-line treatment,’ said lead investigator Robert Motzer, MD, attending physician in the genitourinary oncology service at the Memorial Sloan Kettering Cancer Center and professor of medicine at Weill Medical College at Cornell University in New York City.

“However, ‘in first-line therapy, the efficacy of sunitinib appeared to be better than everolimus. It is clear that sunitinib remains the standard first-line therapy,’ he explained.

” ‘The current paradigm of sunitinib followed by everolimus at progression should be maintained. The experimental sequence of everolimus first followed by sunitinib second did not appear to be as effective,’ Dr. Motzer reported.”


Alternative Sunitinib Treatment Schedules for mRCC May be Worth the Switch

“Some patients with metastatic renal cell carcinoma (mRCC) who are switched from a traditional sunitinib treatment schedule to an alternative schedule fare better on survival measures and suffer fewer adverse events, a Japanese study has found.

“The switch from traditional to alternative schedules was recently found to be effective. But, ‘Japanese patients with mRCC experience substantially different [adverse events] than do patients in many other nations, presumably because of underlying genetic differences’, the authors write.

“They retrospectively reviewed the medical records of 54 patients with mRCC who received sunitinib treatment as first-line therapy between May 2006 and June 2012.”