P08.21THE ROLE OF TARGETED THERAPY IN COMPLEX TREATMENT OF PATIENTS WITH BRAIN METASTASES (BM) FROM RENAL CELL CANCER (RCC)

BACKGROUND: About 2-11% of all patients (pts) with RCC develop BM, leading to a poor prognosis and a median survival of 18 years with ECOG performanse status (PS) of 0-2. From June 2009 to January 2014, 16 pts with RCC and BM were enrolled in this study. 14 pts (87,5%) had extracranial metastases. 9 pts received sunitinib, 6 pts received sorafenib and 1 patient received pazopanib until radiologically-verified progressive disease. The primary endpoints were objective response rate (ORR) in the brain and in the extracranial lesions, progressive-free survival (PFS) and overall survival. Previous treatment: nephrectomy - 14 pts (87,5%), cytokines - 9 pts (56,3%), targeted therapy (before BM) - 4 pts (37,5%). Local control of BM: previous neurosurgery - 3 pts (18,8%), radiosurgery - 6 pts (37,5%), previous neurosurgery + radiosurgery - 3 pts (18,8%). RESULTS: ORR in the brain was 31,3% (5 partial responses). All partial responses in the brain achieved in patients who received targeted therapy and radiosurgery. Stable disease in the brain was 50,0% (8 pts). 1 patient with stable in the brain received targeted therapy and radiosurgery, 7 pts received targeted therapy. ORR in the extracranial lesions was 25,0% (4 partial responses). Stable disease in the extracranial lesions was 50% (8 pts). The median of PFS was 6 months. The median of overall survival was 10 months. CONCLUSIONS: Surgery and radiotherapy, including radiosurgery, must be considered as optimal local treatment for pts with RCC and BM. Targeted drugs have demonstrated their ability to achiеve a clinical and X-ray verified objective effect (as stabilization in most cases) in treating of pts with disseminated RCC and BM.