Search

Background : Axitinib monotherapy obtained approval in pre-treated metastatic renal cell carcinoma (mRCC) patients and recently in combination with pembrolizumab or avelumab in the first-line setting. However, patient profiles that may obtain increased benefit from this drug and its combinations still need to be identified. Patients and Methods : Retrospective multicentre analysis describing clinical characteristics associated with axitinib long-responder (LR) population by comparing two extreme-response sub-groups (progression-free survival [PFS] ≥9 months versus disease progression/refractory patients [RP]). A multivariate logistic-regression model was used to analyse clinical factors. Efficacy and safety were also analysed. Results : In total, 157 patients who received axitinib in second or subsequent line were evaluated (91 LR and 66 RP). Older age at start of axitinib and haemoglobin levels > LLN were independent predictive factors for LR in multivariate analyses. In LR patients, median (m) PFS was 18.1 months, median overall survival (OS) was 36.0 months and objective response rate (ORR) was 45.5%. In 59 LR patients receiving axitinib in second-line, mPFS was 18.7 months, mOS was 44.8 months and ORR was 43.9%. mOS was significantly longer in second line compared to subsequent lines (44.8 versus 26.5 months; P=0.009). In LR versus RP, mPFS with sunitinib in first-line was correlated with mPFS with axitinib in second-line (27.2 versus 10.9 months P Conclusions : This study confirms the long-term benefits of axitinib in a selected population, helping clinicians to select the best sequential approach and patients who could obtain a greater benefit from axitinib. Microabstract Patients with metastatic renal cell carcinoma (mRCC) who may benefit most from axitinib still need to be identified. AXILONG study confirms long-term benefits in a selected population in which age at axitinib initiation and haemoglobin baseline levels were significantly associated although further validation may be required. First-line sunitinib outcomes were also correlated with prolonged response. These results might be helpful in real-life management of mRCC patients.

To analyse the effectiveness and safety of daptomycin versus vancomycin on the management catheter-related bloodstream nfections in oncology patients.A retrospective study was carried out including all patients admitted at the Medical Oncology Unit between 2010 and 2018 with positive blood cultures confirmed catheter-related bloodstream infections due to gram- positive microorganism, who were treated with either vancomycin or daptomycin. The primary end point was all cause 30-days mortality, 30-days hospital readmission and length of hospital stay (length of hospital stay). Results: A total of 70 patients with catheter-related bloodstream infections were included in the present study: vancomycin was administered to 61.4% (n = 43) and daptomycin to 38.6% (n = 27) of patients. 78.5% (n = 55) of isolated bacteria showed a vancomycin minimum inhibitory concentration ≤ 1 μg/ml. No differences were observed between the two groups of patients regarding the 30-day mortality rate rate (32.6% [n = 14] versus 29.6% [n = 8]; p = 0.797), the 30-day re-admission rate (30.2% [n = 13] versus 29.6% [n = 8]; p = 0.957) or the length of hospital stay (18.9 versus 16.5 days; p = 0.562). Nephrotoxicity rate was equivalent in both groups: a 7% (n = 3) of vancomycin goup versus a 7.4% (n = 2) of daptomycin group (p = 0.946).Our results show that both antibiotics are equivalent in their safety and effectiveness. Therefore, vancomycin should continue being the treatment of chose for gram-positive catheter-related bloodstream infections, in particular at hospital centres with a low prevalence of strains that show diminished susceptibility to vancomycin.Analizar la eficacia y seguridad de la daptomicina frente a la vancomicina en el tratamiento de las infecciones del torrente sanguíneo asociadas a catéter vascular en pacientes oncológicos.Método: Se realizó un estudio retrospectivo que incluyó a los pacientes ingresados en la Unidad de Oncología-Médica entre 2010-2018 con infección del torrente sanguíneo asociada a catéter vascular causada por grampositivos, y que fueron tratados con vancomicina o daptomicina. Como objetivos principales se determinaron la tasa de mortalidad por todas las causas a los 30 días, el reingreso hospitalario a los 30 días y la duración de la estancia hospitalaria.El estudio incluyó 70 pacientes con infecciones del torrente sanguíneo asociadas a catéter vascular: el 61,4% (n = 43) recibió vancomicina y el 38,6% (n = 27) daptomicina. El 78,5% (n = 55) de las bacterias aisladas presentaron una concentración mínima inhibitoria de vancomicina ≤ 1 μg/ml. No se observaron diferencias entre ambos grupos de pacientes en cuanto a la tasa de mortalidad a 30 días (32,6% [n = 14] frente al 29,6% [n = 8]; p = 0,797), la tasa de reingreso a 30 días (30,2% [n = 13] frente al 29,6% [n = 8]; p = 0,957) o la duración de la hospitalización (18,9 frente a 16,5 días; p = 0,562). La tasa de nefrotoxicidad fue equivalente en ambos grupos: 7% (n = 3) para vancomicina frente al 7,4% (n = 2) para daptomicina (p = 0,946).Nuestros resultados muestran que ambos antibióticos son equivalentes en su seguridad y eficacia. Por ello, vancomicina debería seguir siendo el tratamiento de elección para la infección del torrente sanguíneo asociada a catéter vascular, especialmente en centros con una baja prevalencia de cepas con una susceptibilidad disminuida a ancomicina.