original articles
Annals of Oncology 24: 2963–2967, 2013 doi:10.1093/annonc/mdt423 Published online 4 November 2013
Triple combination of bevacizumab, gemcitabine and platinum salt in metastatic collecting duct carcinoma N. Pécuchet1,2*, F. Bigot1,2, J. Gachet1,2, C. Massard3, L. Albiges3, C. Teghom1, Y. Allory4, A. Méjean2,5, B. Escudier3 & S. Oudard1,2 1 Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris; 2Unit of Formation and Research in Medicine, University Paris Descartes, Sorbonne Paris Cité, Paris 5; 3Department of Medical Oncology, Institut Gustave Roussy, Villejuif; 4Department of Pathology, Hôpital Henri Mondor, Créteil; 5Department of Urology, Hôpital Européen Georges Pompidou, Paris, France
introduction Renal cell carcinoma (RCC) is the most common type of kidney cancer, with an estimated incidence of 88 400 new cases each year in Europe [1]. Incidence is increasing by about 2% annually. The clear-cell subtype (ccRCC) accounts for 75% of RCCs. The remaining 25% include papillary, chromophobe, collecting duct, medullary, Xp11.2 translocation and unclassified RCC [2]. Collecting duct carcinoma (CDC), recognized as a separate entity in 1986, accounts for 5 months PR = 7 months No response SD: 3/4 patients SD: 4/6 (median PFS, 3.1 months) PR > 13 months Long-lasting disease control: 1 patient sorafenib (33 months) followed by sunitinib (10 months) 1 patient temsirolimus (6 months) followed by sunitinib (9 months) Case report (n = 1) tubulocystic carcinomaa Case report (n = 1) Case report (n = 2) Phase II trial of non-cc RCC (n = 4/15) Phase II trial of non-cc RCC (n = 6b/57) Case report (n = 1) Case report (n = 7) Sunitinib Sunitinib Sunitinib Sunitinib Sunitinib Sorafenib 4 sorafenib 1 sunitinib 2 temsirolimus
Study type (No. of CDC patients) Drug
Kinase inhibitors Mego et al. [28] Miyake et al. [29] Staehler et al. [30] Molina et al. [31] Tannir et al. [32] Ansari et al. [33] Procopio et al. [34]
Table 3. Studies of targeted therapy in mCDC patients
| Pécuchet et al.
Annals of Oncology
1. Ljungberg B, Campbell SC, Cho HY et al. The epidemiology of renal cell carcinoma. Eur Urol 2011; 60: 615–621. 2. Eble JN, Sauter G, Epstein J et al. Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. Lyon: IARC 2004; 1–79. 3. Fleming S, Lewi HJ. Collecting duct carcinoma of the kidney. Histopathology 1986; 10: 1131–1141. 4. Motzer RJ, Bacik J, Mariani T et al. Treatment outcome and survival associated with metastatic renal cell carcinoma of non-clear-cell histology. J Clin Oncol 2002; 20: 2376–2381. 5. Kafé H, Verbavatz J-M, Cochand-Priollet B et al. Collecting duct carcinoma: an entity to be redefined? Virchows Arch 2004; 445: 637–640. 6. Oudard S, Banu E, Vieillefond A et al. Prospective multicenter phase II study of gemcitabine plus platinum salt for metastatic collecting duct carcinoma: results of a GETUG (Groupe d’Etudes des Tumeurs Uro-Génitales) study. J Urol 2007; 177: 1698–1702. 7. Hahn NM, Stadler WM, Zon RT et al. Phase II trial of cisplatin, gemcitabine, and bevacizumab as first-line therapy for metastatic urothelial carcinoma: Hoosier Oncology Group GU 04–75. J Clin Oncol 2011; 29: 1525–1530. 8. Balar AV, Apolo AB, Ostrovnaya I et al. Phase II study of gemcitabine, carboplatin, and bevacizumab in patients with advanced unresectable or metastatic urothelial cancer. J Clin Oncol 2013; 31: 724–730. 9. Barrascout E, Beuselinck B, Ayllon J et al. Complete remission of pulmonary metastases of Bellini duct carcinoma with cisplatin, gemcitabine and bevacizumab. Am J Case Rep 2012; 13: 1–2. 10. Motzer RJ, Bacik J, Murphy BA et al. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol 2002; 20: 289–296. 11. Heng DYC, Xie W, Regan MM et al. External validation and comparison with other models of the international metastatic renal-cell carcinoma database consortium prognostic model: a population-based study. Lancet Oncol 2013; 14: 141–148. 12. Srigley JR, Delahunt B. Uncommon and recently described renal carcinomas. Mod Pathol 2009; 22(Suppl 2):S2–S23. 13. Wright JL, Risk MC, Hotaling J et al. Effect of collecting duct histology on renal cell cancer outcome. J Urol 2009; 182: 2595–2599. 14. Méjean A, Roupret M, Larousserie F et al. Is there a place for radical nephrectomy in the presence of metastatic collecting duct (Bellini) carcinoma? J Urol 2003; 169: 1287–1290. 15. Karakiewicz PI, Trinh Q-D, Rioux-Leclercq N et al. Collecting duct renal cell carcinoma: a matched analysis of 41 cases. Eur Urol 2007; 52: 1140–1145. 16. Tokuda N, Naito S, Matsuzaki O et al. Collecting duct (Bellini duct) renal cell carcinoma: a nationwide survey in Japan. J Urol 2006; 176: 40. –43. ; discussion 43. 17. Kuroda N, Toi M, Hiroi M et al. Review of collecting duct carcinoma with focus on clinical and pathobiological aspects. Histopathology 2002; 17: 1329–1334. 18. Srigley JR, Eble JN. Collecting duct carcinoma of kidney. Semin Diagn Pathol 1998; 15: 54–67. 19. Kobayashi N, Matsuzaki O, Shirai S et al. Collecting duct carcinoma of the kidney: an immunohistochemical evaluation of the use of antibodies for differential diagnosis. Hum Pathol 2008; 39: 1350–1359. 20. Selli C, Amorosi A, Vona G et al. Retrospective evaluation of c-erbB-2 oncogene amplification using competitive PCR in collecting duct carcinoma of the kidney. J Urol 1997; 158: 245–247. 21. Fine SW, Argani P, DeMarzo AM et al. Expanding the histologic spectrum of mucinous tubular and spindle cell carcinoma of the kidney. Am J Surg Pathol 2006; 30: 1554–1560. 22. Gupta R, Billis A, Shah RB et al. Carcinoma of the collecting ducts of Bellini and renal medullary carcinoma: clinicopathologic analysis of 52 cases of rare aggressive subtypes of renal cell carcinoma with a focus on their interrelationship. Am J Surg Pathol 2012; 36: 1265–1278. 23. Calderaro J, Moroch J, Pierron G et al. SMARCB1/INI1 Inactivation in renal medullary carcinoma. Histopathology 2012; 61: 428–435. 24. Orsola A, Trias I, Raventós CX et al. Renal collecting (Bellini) duct carcinoma displays similar characteristics to upper tract urothelial cell carcinoma. Urology 2005; 65: 49–54.
Volume 24 | No. 12 | December 2013
Downloaded from http://annonc.oxfordjournals.org/ at University of Virginia on December 3, 2013
Outcomes
original articles
original articles
Annals of Oncology 25. Chao D, Zisman A, Pantuck AJ et al. Collecting duct renal cell carcinoma: clinical study of a rare tumor. J Urol 2002; 167: 71–74. 26. Dimopoulos MA, Logothetis CJ, Markowitz A et al. Collecting duct carcinoma of the kidney. Br J Urol 1993; 71: 388–391. 27. Peyromaure M, Thiounn N, Scotté F et al. Collecting duct carcinoma of the kidney: a clinicopathological study of 9 cases. J Urol 2003; 170: 1138–1140. 28. Mego M, Sycova-Mila Z, Rejlekova K et al. Sunitinib in the treatment of tubulocystic carcinoma of the kidney. A case report. Ann Oncol 2008; 19: 1655–1656. 29. Miyake H, Haraguchi T, Takenaka A et al. Metastatic collecting duct carcinoma of the kidney responded to sunitinib. Int J Clin Oncol 2011; 16: 153–155. 30. Staehler M, Schöppler G, Haseke N et al. Carcinoma of the collecting ducts of Bellini of the kidney: adjuvant chemotherapy followed by multikinase inhibition with sunitinib. Clin Genitourin Cancer 2009; 7: 58–61.
31. Molina AM, Feldman DR, Ginsberg MS et al. Phase II trial of sunitinib in patients with metastatic non-clear cell renal cell carcinoma. Invest New Drugs 2010; 30: 335–340. 32. Tannir NM, Plimack E, Ng C et al. A phase 2 trial of sunitinib in patients with advanced non-clear cell renal cell carcinoma. Eur Urol 2012; 62: 1013–1019. 33. Ansari J, Fatima A, Chaudhri S et al. Sorafenib induces therapeutic response in a patient with metastatic collecting duct carcinoma of kidney. Onkologie 2009; 32: 44–46. 34. Procopio G, Verzoni E, Iacovelli R et al. Is there a role for targeted therapies in the collecting ducts of Bellini carcinoma? Efficacy data from a retrospective analysis of 7 cases. Clin Exp Nephrol 2012; 16: 464–467. 35. Bronchud MH, Castillo S, Escriva de Romani S et al. HER2 Blockade in metastatic collecting duct carcinoma (CDC) of the kidney: a case report. Onkologie 2012; 35: 776–779.
Overall survival for sorafenib plus interleukin-2 compared with sorafenib alone in metastatic renal cell carcinoma (mRCC): final results of the ROSORC trial† G. Procopio1*, E. Verzoni1, S. Bracarda2, S. Ricci3, C. Sacco4, L. Ridolfi5, C. Porta6, R. Miceli7, N. Zilembo1 & E. Bajetta8, on behalf of Italian Trials in Medical Oncology (ITMO) group 1
Department of Medical Oncology, Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan; 2Department of Medical Oncology, San Donato Hospital, Arezzo; Department of Medical Oncology, Santa Chiara Hospital, Pisa; 4Department of Medical Oncology, University Hospital, Udine; 5Department of Medical Oncology, I.R.S.T, Meldola; 6Department of Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia; 7Unit of Clinical Epidemiology and trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan; 8Department of Medical Oncology, Policlinico Monza, Monza, Italy 3
Received 26 February 2013; revised 23 May 2013 and 8 July 2013; accepted 5 August 2013
Background: The ROSORC trial, a randomised, phase II trial comparing sorafenib plus interleukin (IL-2) versus sorafenib alone as first-line treatment of metastatic renal cell carcinoma (mRCC) failed to demonstrate differences in progression-free survival (PFS). Updated overall survival (OS) results are reported. Patients and methods: In this study, 128 patients were randomised to receive sorafenib 400 mg twice daily plus subcutaneous IL-2 4.5 million international units (MIU) five times per week for 6 weeks every 8 weeks (arm A) or sorafenib alone (arm B). OS was estimated with the Kaplan–Meier method and compared with the two-sided log-rank test. Results: After a median follow-up of 58 months (interquartile range: 28–63 months), the median OS was 38 and 33 months in arms A and B, respectively (P = 0.667). The 5-year OS was 26.3% [95% confidence interval (CI) 15.9–43.5) and 23.1% (95% CI 13.2–40.5) for the combination- and single-agent arm, respectively. Most of the patients who were refractory to first-line treatment were subsequently treated with different targeted agents; they had a median survival greater than expected. Conclusions: This outcome suggests a synergistic effect of the subsequent therapies following sorafenib failure. ClinicalTrials.gov Identifier: NCT00609401. Key words: renal cell carcinoma, sorafenib, interleukin-2, first-line treatment, targeted therapies
*Correspondence to: Dr Giuseppe Procopio, Department of Medical Oncology, Unit 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Via G.Venezian 1, 20133, Milan, Italy. Tel: +39-02-2390-4450; Fax: +39-02-2390-2149; E-mail: [email protected] †
Data from this study were presented in part at the 2013 Genitourinary Cancer Symposium, Orlando, FL, February 14–16.
© The Author 2013. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from http://annonc.oxfordjournals.org/ at University of Virginia on December 3, 2013
Annals of Oncology 24: 2967–2971, 2013 doi:10.1093/annonc/mdt375 Published online 24 September 2013
Annals of Oncology 24: 2963–2967, 2013 doi:10.1093/annonc/mdt423 Published online 4 November 2013
Triple combination of bevacizumab, gemcitabine and platinum salt in metastatic collecting duct carcinoma N. Pécuchet1,2*, F. Bigot1,2, J. Gachet1,2, C. Massard3, L. Albiges3, C. Teghom1, Y. Allory4, A. Méjean2,5, B. Escudier3 & S. Oudard1,2 1 Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris; 2Unit of Formation and Research in Medicine, University Paris Descartes, Sorbonne Paris Cité, Paris 5; 3Department of Medical Oncology, Institut Gustave Roussy, Villejuif; 4Department of Pathology, Hôpital Henri Mondor, Créteil; 5Department of Urology, Hôpital Européen Georges Pompidou, Paris, France
introduction Renal cell carcinoma (RCC) is the most common type of kidney cancer, with an estimated incidence of 88 400 new cases each year in Europe [1]. Incidence is increasing by about 2% annually. The clear-cell subtype (ccRCC) accounts for 75% of RCCs. The remaining 25% include papillary, chromophobe, collecting duct, medullary, Xp11.2 translocation and unclassified RCC [2]. Collecting duct carcinoma (CDC), recognized as a separate entity in 1986, accounts for 5 months PR = 7 months No response SD: 3/4 patients SD: 4/6 (median PFS, 3.1 months) PR > 13 months Long-lasting disease control: 1 patient sorafenib (33 months) followed by sunitinib (10 months) 1 patient temsirolimus (6 months) followed by sunitinib (9 months) Case report (n = 1) tubulocystic carcinomaa Case report (n = 1) Case report (n = 2) Phase II trial of non-cc RCC (n = 4/15) Phase II trial of non-cc RCC (n = 6b/57) Case report (n = 1) Case report (n = 7) Sunitinib Sunitinib Sunitinib Sunitinib Sunitinib Sorafenib 4 sorafenib 1 sunitinib 2 temsirolimus
Study type (No. of CDC patients) Drug
Kinase inhibitors Mego et al. [28] Miyake et al. [29] Staehler et al. [30] Molina et al. [31] Tannir et al. [32] Ansari et al. [33] Procopio et al. [34]
Table 3. Studies of targeted therapy in mCDC patients
| Pécuchet et al.
Annals of Oncology
1. Ljungberg B, Campbell SC, Cho HY et al. The epidemiology of renal cell carcinoma. Eur Urol 2011; 60: 615–621. 2. Eble JN, Sauter G, Epstein J et al. Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. Lyon: IARC 2004; 1–79. 3. Fleming S, Lewi HJ. Collecting duct carcinoma of the kidney. Histopathology 1986; 10: 1131–1141. 4. Motzer RJ, Bacik J, Mariani T et al. Treatment outcome and survival associated with metastatic renal cell carcinoma of non-clear-cell histology. J Clin Oncol 2002; 20: 2376–2381. 5. Kafé H, Verbavatz J-M, Cochand-Priollet B et al. Collecting duct carcinoma: an entity to be redefined? Virchows Arch 2004; 445: 637–640. 6. Oudard S, Banu E, Vieillefond A et al. Prospective multicenter phase II study of gemcitabine plus platinum salt for metastatic collecting duct carcinoma: results of a GETUG (Groupe d’Etudes des Tumeurs Uro-Génitales) study. J Urol 2007; 177: 1698–1702. 7. Hahn NM, Stadler WM, Zon RT et al. Phase II trial of cisplatin, gemcitabine, and bevacizumab as first-line therapy for metastatic urothelial carcinoma: Hoosier Oncology Group GU 04–75. J Clin Oncol 2011; 29: 1525–1530. 8. Balar AV, Apolo AB, Ostrovnaya I et al. Phase II study of gemcitabine, carboplatin, and bevacizumab in patients with advanced unresectable or metastatic urothelial cancer. J Clin Oncol 2013; 31: 724–730. 9. Barrascout E, Beuselinck B, Ayllon J et al. Complete remission of pulmonary metastases of Bellini duct carcinoma with cisplatin, gemcitabine and bevacizumab. Am J Case Rep 2012; 13: 1–2. 10. Motzer RJ, Bacik J, Murphy BA et al. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol 2002; 20: 289–296. 11. Heng DYC, Xie W, Regan MM et al. External validation and comparison with other models of the international metastatic renal-cell carcinoma database consortium prognostic model: a population-based study. Lancet Oncol 2013; 14: 141–148. 12. Srigley JR, Delahunt B. Uncommon and recently described renal carcinomas. Mod Pathol 2009; 22(Suppl 2):S2–S23. 13. Wright JL, Risk MC, Hotaling J et al. Effect of collecting duct histology on renal cell cancer outcome. J Urol 2009; 182: 2595–2599. 14. Méjean A, Roupret M, Larousserie F et al. Is there a place for radical nephrectomy in the presence of metastatic collecting duct (Bellini) carcinoma? J Urol 2003; 169: 1287–1290. 15. Karakiewicz PI, Trinh Q-D, Rioux-Leclercq N et al. Collecting duct renal cell carcinoma: a matched analysis of 41 cases. Eur Urol 2007; 52: 1140–1145. 16. Tokuda N, Naito S, Matsuzaki O et al. Collecting duct (Bellini duct) renal cell carcinoma: a nationwide survey in Japan. J Urol 2006; 176: 40. –43. ; discussion 43. 17. Kuroda N, Toi M, Hiroi M et al. Review of collecting duct carcinoma with focus on clinical and pathobiological aspects. Histopathology 2002; 17: 1329–1334. 18. Srigley JR, Eble JN. Collecting duct carcinoma of kidney. Semin Diagn Pathol 1998; 15: 54–67. 19. Kobayashi N, Matsuzaki O, Shirai S et al. Collecting duct carcinoma of the kidney: an immunohistochemical evaluation of the use of antibodies for differential diagnosis. Hum Pathol 2008; 39: 1350–1359. 20. Selli C, Amorosi A, Vona G et al. Retrospective evaluation of c-erbB-2 oncogene amplification using competitive PCR in collecting duct carcinoma of the kidney. J Urol 1997; 158: 245–247. 21. Fine SW, Argani P, DeMarzo AM et al. Expanding the histologic spectrum of mucinous tubular and spindle cell carcinoma of the kidney. Am J Surg Pathol 2006; 30: 1554–1560. 22. Gupta R, Billis A, Shah RB et al. Carcinoma of the collecting ducts of Bellini and renal medullary carcinoma: clinicopathologic analysis of 52 cases of rare aggressive subtypes of renal cell carcinoma with a focus on their interrelationship. Am J Surg Pathol 2012; 36: 1265–1278. 23. Calderaro J, Moroch J, Pierron G et al. SMARCB1/INI1 Inactivation in renal medullary carcinoma. Histopathology 2012; 61: 428–435. 24. Orsola A, Trias I, Raventós CX et al. Renal collecting (Bellini) duct carcinoma displays similar characteristics to upper tract urothelial cell carcinoma. Urology 2005; 65: 49–54.
Volume 24 | No. 12 | December 2013
Downloaded from http://annonc.oxfordjournals.org/ at University of Virginia on December 3, 2013
Outcomes
original articles
original articles
Annals of Oncology 25. Chao D, Zisman A, Pantuck AJ et al. Collecting duct renal cell carcinoma: clinical study of a rare tumor. J Urol 2002; 167: 71–74. 26. Dimopoulos MA, Logothetis CJ, Markowitz A et al. Collecting duct carcinoma of the kidney. Br J Urol 1993; 71: 388–391. 27. Peyromaure M, Thiounn N, Scotté F et al. Collecting duct carcinoma of the kidney: a clinicopathological study of 9 cases. J Urol 2003; 170: 1138–1140. 28. Mego M, Sycova-Mila Z, Rejlekova K et al. Sunitinib in the treatment of tubulocystic carcinoma of the kidney. A case report. Ann Oncol 2008; 19: 1655–1656. 29. Miyake H, Haraguchi T, Takenaka A et al. Metastatic collecting duct carcinoma of the kidney responded to sunitinib. Int J Clin Oncol 2011; 16: 153–155. 30. Staehler M, Schöppler G, Haseke N et al. Carcinoma of the collecting ducts of Bellini of the kidney: adjuvant chemotherapy followed by multikinase inhibition with sunitinib. Clin Genitourin Cancer 2009; 7: 58–61.
31. Molina AM, Feldman DR, Ginsberg MS et al. Phase II trial of sunitinib in patients with metastatic non-clear cell renal cell carcinoma. Invest New Drugs 2010; 30: 335–340. 32. Tannir NM, Plimack E, Ng C et al. A phase 2 trial of sunitinib in patients with advanced non-clear cell renal cell carcinoma. Eur Urol 2012; 62: 1013–1019. 33. Ansari J, Fatima A, Chaudhri S et al. Sorafenib induces therapeutic response in a patient with metastatic collecting duct carcinoma of kidney. Onkologie 2009; 32: 44–46. 34. Procopio G, Verzoni E, Iacovelli R et al. Is there a role for targeted therapies in the collecting ducts of Bellini carcinoma? Efficacy data from a retrospective analysis of 7 cases. Clin Exp Nephrol 2012; 16: 464–467. 35. Bronchud MH, Castillo S, Escriva de Romani S et al. HER2 Blockade in metastatic collecting duct carcinoma (CDC) of the kidney: a case report. Onkologie 2012; 35: 776–779.
Overall survival for sorafenib plus interleukin-2 compared with sorafenib alone in metastatic renal cell carcinoma (mRCC): final results of the ROSORC trial† G. Procopio1*, E. Verzoni1, S. Bracarda2, S. Ricci3, C. Sacco4, L. Ridolfi5, C. Porta6, R. Miceli7, N. Zilembo1 & E. Bajetta8, on behalf of Italian Trials in Medical Oncology (ITMO) group 1
Department of Medical Oncology, Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan; 2Department of Medical Oncology, San Donato Hospital, Arezzo; Department of Medical Oncology, Santa Chiara Hospital, Pisa; 4Department of Medical Oncology, University Hospital, Udine; 5Department of Medical Oncology, I.R.S.T, Meldola; 6Department of Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia; 7Unit of Clinical Epidemiology and trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan; 8Department of Medical Oncology, Policlinico Monza, Monza, Italy 3
Received 26 February 2013; revised 23 May 2013 and 8 July 2013; accepted 5 August 2013
Background: The ROSORC trial, a randomised, phase II trial comparing sorafenib plus interleukin (IL-2) versus sorafenib alone as first-line treatment of metastatic renal cell carcinoma (mRCC) failed to demonstrate differences in progression-free survival (PFS). Updated overall survival (OS) results are reported. Patients and methods: In this study, 128 patients were randomised to receive sorafenib 400 mg twice daily plus subcutaneous IL-2 4.5 million international units (MIU) five times per week for 6 weeks every 8 weeks (arm A) or sorafenib alone (arm B). OS was estimated with the Kaplan–Meier method and compared with the two-sided log-rank test. Results: After a median follow-up of 58 months (interquartile range: 28–63 months), the median OS was 38 and 33 months in arms A and B, respectively (P = 0.667). The 5-year OS was 26.3% [95% confidence interval (CI) 15.9–43.5) and 23.1% (95% CI 13.2–40.5) for the combination- and single-agent arm, respectively. Most of the patients who were refractory to first-line treatment were subsequently treated with different targeted agents; they had a median survival greater than expected. Conclusions: This outcome suggests a synergistic effect of the subsequent therapies following sorafenib failure. ClinicalTrials.gov Identifier: NCT00609401. Key words: renal cell carcinoma, sorafenib, interleukin-2, first-line treatment, targeted therapies
*Correspondence to: Dr Giuseppe Procopio, Department of Medical Oncology, Unit 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Via G.Venezian 1, 20133, Milan, Italy. Tel: +39-02-2390-4450; Fax: +39-02-2390-2149; E-mail: [email protected] †
Data from this study were presented in part at the 2013 Genitourinary Cancer Symposium, Orlando, FL, February 14–16.
© The Author 2013. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from http://annonc.oxfordjournals.org/ at University of Virginia on December 3, 2013
Annals of Oncology 24: 2967–2971, 2013 doi:10.1093/annonc/mdt375 Published online 24 September 2013
