http://www.urowiki.or.kr/wiki/index.php?action=history&feed=atom&title=Metastatic_Renal_CancerMetastatic Renal Cancer - 편집 역사2026-05-06T06:23:57Z이 문서의 편집 역사MediaWiki 1.35.11http://www.urowiki.or.kr/wiki/index.php?title=Metastatic_Renal_Cancer&diff=3058&oldid=prevSjlee: 새 문서: Predictors of short survival Poor prognosis patients are defined as those with ≥ 3 predictors of short survival - LDH level > 1.5 times upper limit of normal - Hgb level < lower...2019-06-26T07:04:34Z<p>새 문서: Predictors of short survival Poor prognosis patients are defined as those with ≥ 3 predictors of short survival - LDH level > 1.5 times upper limit of normal - Hgb level < lower...</p>
<p><b>새 문서</b></p><div><br />
Predictors of short survival<br />
<br />
Poor prognosis patients are defined as those with ≥ 3 predictors of short survival<br />
<br />
- LDH level > 1.5 times upper limit of normal<br />
<br />
- Hgb level < lower limit normal<br />
<br />
- Corrected serum calcium level > 10mg/dl<br />
<br />
- Interval of less than a year from original diagnosis to the start of systemic therapy<br />
<br />
- Karnofsky PS ≤ 70<br />
<br />
- ≥ 2 sites of organ metastasis<br />
<br />
NCCN guideline 2013.<br />
<br />
1) Sunitinib (Sutene)-clear cell type 경우<br />
: Sunitinib 50mg PO for 4weeks, 2weeks off every 6-week toxicity 시 감량: 37.5mg/day<br />
: Response Rate: 31% PFS:11months Ref> NEJM 2007;356:115-124<br />
2) Sorafenib (Nexavar)-clear cell type 경우<br />
: Nexavar 400mg PO Bid (공복시 복용)<br />
: toxicity 시 감량: 400mg/day → 400mg EOD<br />
: PFS:5.5months vs 2.8month (sorafenib vs placebo)<br />
: RR: 10% vs 8%(sorafenib vs placebo Ref> NEJM 2007;356:125-134<br />
3) Pazopanib (Votrient)-clear cell type 경우<br />
: 800mg/day PO toxicity 시 감량: 400mg/day<br />
: Pazopanib vs. placebo 9.2 vs. 4.2months Ref> JCO 2010;28:1061<br />
4) Temsirolimus (Torisel)-non clear cell type, poor prognosis in clear cell type<br />
: Temsirolimus 25mg iv for 30min weekly<br />
: overall survival:10.9month PFS:3.8month Response<br />
: Rate:8.6% Ref> NEJM 2007;356:2271-2281<br />
5) Everolimus (Afinitor)-second line<br />
: 10mg/day PO toxicity 시 감량: 5mg/day<br />
: mPFS: everolimus vs. placebo 4.0 vs. 1months<br />
6) High dose IL-2<br />
: 대상: ECOG PS 0-1, normal organ function<br />
: HD IL-2 (600,000 U/kg/dose IV every 8hrs on days 1 through 5 and 15 to 19 [maximum 28 doses]) every 12weeks<br />
: Ref> JCO 2005;23:133</div>Sjlee