Outcomes of patients with metastatic renal cell carcinoma and end-stage renal disease receiving dialysis and targeted therapies: a single institution experience

Clin Genitourin Cancer. 2014 Oct;12(5):348-53. doi: 10.1016/j.clgc.2014.01.004. Epub 2014 Jan 18.


Introduction: Limited data are available regarding patients with renal cell carcinoma and ESRD treated with TTs. The objective of this study was to explore the tolerability and safety of TT in patients with mRCC and ESRD.

Patients and methods: We retrospectively identified patients with mRCC and ESRD treated at the University of Texas M.D. Anderson Cancer Center from 2002 to 2012. Patient characteristics including demographic, histology, treatment, and adverse events are reported. Duration of treatment (TOT) was determined from date of drug initiation to discontinuation. Overall survival (OS) was determined from initiation of TT to death. Statistics are descriptive.

Results: Fourteen patients were identified. Ten patients had clear-cell histology and 4 had papillary histology. The median number of TTs per patient was 3 (range, 1-4) with median TOT of 28 months for all TTs. Eighty-eight percent of all toxicities were Grade 1 to 2; no Grade 4 toxicities were noted. Treatment discontinuations included 3 patients treated with sorafenib due to hand-foot syndrome, intolerable fatigue, and squamous cell skin cancer development; 2 patients treated with pazopanib due to intolerable fatigue and increased transaminase levels; and 1 patient treated with everolimus due to pneumonitis. Eight patients died from progressive disease. Median OS from initiation of TT was 28.5 months and 35 months from time of diagnosis.

Conclusion: Toxicities were mild to moderate and consistent with those reported in previous studies. TTs appear to be safe, well tolerated and produce antitumor response in patients with mRCC and ESRD receiving dialysis.

Keywords: Hemodialysis; Kidney cancer; Kidney disease; VEGF tyrosine kinase inhibitors; mTOR inhibitors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / mortality
  • Disease-Free Survival
  • Everolimus
  • Female
  • Humans
  • Indazoles
  • Kidney Failure, Chronic / drug therapy*
  • Kidney Failure, Chronic / mortality
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / mortality
  • Male
  • Middle Aged
  • Molecular Targeted Therapy / adverse effects*
  • Niacinamide / adverse effects
  • Niacinamide / analogs & derivatives
  • Niacinamide / therapeutic use
  • Phenylurea Compounds / adverse effects
  • Phenylurea Compounds / therapeutic use
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrimidines / adverse effects
  • Pyrimidines / therapeutic use
  • Renal Dialysis*
  • Retrospective Studies
  • Sirolimus / adverse effects
  • Sirolimus / analogs & derivatives
  • Sirolimus / therapeutic use
  • Sorafenib
  • Sulfonamides / adverse effects
  • Sulfonamides / therapeutic use
  • Treatment Outcome


  • Antineoplastic Agents
  • Indazoles
  • Phenylurea Compounds
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Sulfonamides
  • Niacinamide
  • pazopanib
  • Everolimus
  • Sorafenib
  • Sirolimus