A pooled analysis of the efficacy and safety of sunitinib in elderly patients (pts) with metastatic renal cell carcinoma (mRCC).

Hutson, Thomas E.; Bukowski, Ronald M.; Rini, Brian I.; Gore, M.; Larkin, J.; Figlin, Robert A.; Barrios, Carlos; Escudier, Bernard; Lin, Xun; Fly, K; Martell, Bridget; Matczak, Ewa; Motzer, Robert J.

doi:10.1200/jco.2011.29.15_suppl.4604

Cited by 14 publications

(15 citation statements)

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“…Following first-line therapy, patients in the sunitinib arm achieved a PFS of 8.8 months without toxic drug-related deaths [37]. These provisional observations were confirmed in a larger unpublished pooled analysis including 1059 patients enrolled in five clinical trials and undergoing different lines of treatment [39]. A total of 202 patients were 70 years and older (19%); 857 patients (81%) were younger than 70 years.…”

Section: Sunitinibmentioning

confidence: 81%

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Advanced kidney cancer: treating the elderly

Zustovich

Novara

2013

Expert Review of Anticancer Therapy

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Advancing age represents the primary risk factor for renal tumors. Despite findings on the inhibition of angiogenesis that have led to six new drugs to treat metastatic renal cell carcinoma, elderly patients have not been fully represented in clinical trials. In addition, current opinions regarding nephrectomy in elderly patients are conflicting. Available data refer to the efficacy and safety of sorafenib, sunitinib, everolimus, bevacizumab and temsirolimus in patients aged 65 years and older; safety and efficacy data are available only for sunitinib, sorafenib,and everolimus in patients aged 70 years and older and only sorafenib has safety data for patients aged 75 years and older. A different approach based on evaluating comorbidities at baseline, risk of drug interactions and the impact of antitumor treatment in patients with polytherapy regimen is discussed. A decision-making algorithm is proposed to facilitate the selection of the best therapy for kidney tumors for a specific elderly patient profile.

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Section: Sunitinibmentioning

confidence: 81%

“…Concerning safety, some drugrelated AEs were more common in the elderly: fatigue, loss of appetite/weight, cough, peripheral edema, anemia and thrombocytopenia. On the contrary, the hand-foot-skin reaction was more common in younger patients [39].…”

Section: Sunitinibmentioning

confidence: 97%

Advanced kidney cancer: treating the elderly

Zustovich

Novara

2013

Expert Review of Anticancer Therapy

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“…The efficacy (median PFS and median OS) was similar in both groups. Some adverse events were significantly less common in patients aged < 70 years versus ≥70 years, including fatigue (59% vs 69%), decreased appetite and loss of weight (29% vs 53%), cough (20% vs 29%), peripheral edema (17% vs 27%), anemia (17% vs 25%), and thrombocytopenia (16% vs 25%; all P < 0.05) 64. At the 2012 Genitourinary Cancers American Society of Clinical Oncology Symposium, the authors evaluated toxicity and dose reductions in patients aged ≥ 70 years with metastatic RCC 65.…”

Section: General Treatmentmentioning

confidence: 97%

Optimal management of renal cell carcinoma in the elderly: a review

Quivy¹,

Daste²,

Harbaoui³

et al. 2013

CIA

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Both the aging population and the incidence of renal cell carcinoma (RCC) are growing, making the question of tumor management in the elderly a real challenge. Doctors should be aware of the importance of assessing this specific subpopulation. An aggressive therapeutic approach may be balanced by the benefit of the treatment — care or cure — and the life expectancy and willingness of the patient. The treatment for local disease can be surgery (radical or partial nephrectomy) or ablative therapies (radiofrequency, cryotherapy). Even if in most cases surgery is safe, complications such as alteration of renal function may occur, especially in the elderly, with physiological renal impairment at baseline. More recently, another option has been developed as an alternative: active surveillance. In the past decade, new drugs have been approved in the metastatic setting. All the phase 3 trials have included patients without a limit on age. Nevertheless, data concerning the elderly are still poor and concern only a very selective subpopulation. The toxicity profile of targeted agents may interfere with pre-existent comorbidities. Furthermore, the metabolism of several agents via cytochrome P450 can cause drug interaction. The importance of quality of life is a major factor with regard to management of therapy. Finally, to date, there is no recommendation of systematic a priori dose reduction in the elderly. In this review we describe the various possibilities of treatment for localized RCC or metastatic RCC in an aging population.

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“…Due to the lack of information regarding tolerability in this group, and the general frailty of this population, elderly people are usually under-treated [88]. Nevertheless, in subgroup analysis, it seems that efficacy of TKIs (sunitinib, sorafenib) is similar to that in younger populations [89,90]. In studies with temsirolimus [48], pazopanib [38] and axitinib [42] there was also no difference in efficacy, but the age cut-off was with inclusion of marginally younger patients (65 years) than for the two other agents (70 years).…”

Section: Elderly Patientsmentioning

confidence: 99%

Protein kinase inhibitors in renal cell carcinoma

Daste

Grellety

Gross‐Goupil

et al. 2013

Expert Opinion on Pharmacotherapy

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VEGF TKI and m-TOR inhibitors have significantly improved the outcome of mRCC and offer a gain in survival by sequential treatments for the majority of patients. But they induce a particular toxicity profile. An adequate management of each drug and its sequence in treatment is essential to optimise the outcome and preserve the quality of life (QoL) of patients with mRCC. In forthcoming years, pending results should indicate whether VEGF TKI are of interest in an adjuvant setting and if new drugs targeting will challenge the current standard guidelines in the metastatic setting.

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A pooled analysis of the efficacy and safety of sunitinib in elderly patients (pts) with metastatic renal cell carcinoma (mRCC).

Cited by 14 publications

References 0 publications

Advanced kidney cancer: treating the elderly

Advanced kidney cancer: treating the elderly

Optimal management of renal cell carcinoma in the elderly: a review

Protein kinase inhibitors in renal cell carcinoma

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