Comprehensive geriatric assessment is an independent prognostic factor in older patients with metastatic renal cell cancer treated with first-line Sunitinib or Pazopanib: a single center experience

Pierantoni, Francesco; Basso, Umberto; Maruzzo, Marco; Lamberti, E.; Bimbatti, Davide; Tierno, Giuseppina; Bergo, Eleonora; Brunello, Antonella; Zagonel, Vittorina

doi:10.1016/j.jgo.2020.09.009

Cited by 12 publications

(8 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More than one-third of our patients had >70 years and showed a superior incidence of grade 3–4 events (45.3%), although not statistically significant. In this setting, multidimensional geriatric parameters may help to identify those patients at an increased incidence of toxicities and guide precautionary dose adjustments [21]. We registered a superimposable rate of temporary treatment interruptions (17.2 vs. 19% of patients), dose reductions (17.2 vs. 14% of patients), and early discontinuation due to toxicity (5.8 vs. 5% of patients) compared to the TIVO-1 study [7], thus proving that the favorable toxicity profile of tivozanib is maintained also in a less selected population of patients.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Tivozanib in First-Line mRCC: A Multicenter Compassionate-Use Study (Meet-Uro 16)

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction: Tivozanib is a potent and selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor 1 (VEGFR-1), VEGFR-2, and VEGFR-3, recently approved in Europe for the first-line treatment of metastatic renal cell carcinoma (mRCC). Methods: Retrospective analysis of safety and activity of tivozanib administered at 1.34 mg daily (3 weeks on, 1 week off) within a compassionate-use program to patients with mRCC with no prior systemic treatment in Italy. Results: From August 2018 to April 2019, 64 patients have started tivozanib in 9 oncology units. The median age was 67.5 years (range 40–85), 62.5% males. According to International Metastatic Renal Cell Carcinoma Database Consortium criteria, 27.1% of patients were good prognosis, 57.6% intermediate, and 15.3% poor. Primary tumor had been removed in 71.9% of patients. Histology was clear cell 89%, papillary 4.7%, and unclassified 6.3%. The response rate was 34.4%, stable disease 40.6%, and progression 15.6%. Grade 3–4 toxicities were 7.8% hypertension, 4.7% anemia, 3.1% mucositis, 3.1% asthenia, 1.6% diarrhea, 1.6% anorexia, 1.6% worsening of renal function, and 3.1% cardiac events. Dose reduction to 0.89 mg was applied to 17.2% of patients, and the discontinuation rate due to toxicity was 5.8%. Median progression-free survival was 12.4 months, with 68.7% of patients alive at 12 months. The developing of hypertension predicted increased progression-free survival at multivariate analysis (HR, 0.128; 95% CI, 0.03–0.59; p = 0.008). Conclusions: Tivozanib showed good activity and favorable safety profile in a real-world cohort of unselected patients with mRCC. Predictive biomarkers of response to antiangiogenic therapy are urgently needed in order to identify RCC patients who could still receive a monotherapy with VEGFR inhibitors in the first line.

show abstract

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Tivozanib in First-Line mRCC: A Multicenter Compassionate-Use Study (Meet-Uro 16)

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Studies describe the use of a GA in older adults with metastatic kidney cancer receiving TKIs. A retrospective single-institution study of 86 adults age ≥70 years treated with first line sunitinib or pazopanib for metastatic kidney cancer evaluated the ability of a pretreatment GA to predict subsequent treatment toxicity and outcomes ( 20 ). The authors used the GA to categorize patients into either a “fit”, “vulnerable” or “frail” category on the basis of five domains: IADLs, GDS, MMSE, CIRS-G, and polypharmacy.…”

Section: Kidney Cancermentioning

confidence: 99%

“…The authors used the GA to categorize patients into either a “fit”, “vulnerable” or “frail” category on the basis of five domains: IADLs, GDS, MMSE, CIRS-G, and polypharmacy. The pretreatment GA was able to differentiate patients at risk for grade 3 to 4 treatment-related toxicity, shorter progression free survival and shorter overall survival ( 20 ). However, a separate study using pretreatment GA in adults with a median age of 74 years starting sunitinib for metastatic kidney cancer found no correlation between pretreatment frailty as assessed by the GA and subsequent treatment toxicity or disease response ( 76 ).…”

Section: Kidney Cancermentioning

confidence: 99%

Geriatric assessment in the older adult with genitourinary cancer: A narrative review

2023

View full text Add to dashboard Cite

Genitourinary (GU) cancers including bladder, prostate, and kidney cancers affect older adults with a higher prevalence compared to younger adults. GU cancer treatment is associated with poorer outcomes in older adults compared to their younger counterparts. To better identify and support older adults receiving cancer care, oncologic societies recommend the use of a geriatric assessment (GA) to guide management. However, little is known about the implementation and usefulness of the GA in older adults with GU cancers. We performed a narrative review to investigate the utility of the GA in older adults with GU cancers and propose strategies to optimize the real-world use of the GA. Here, we describe a framework to incorporate GA into the routine cancer care of older adults with GU cancers and provide several implications for future research.

show abstract

“…17 Patients who do not respond well to first-line treatment have a significantly worse prognosis and represent a population of patients for whom PSC should be integrated as they move to second-line treatment options. 18 Increasingly, there are geriatric assessment tools to assess frailty in elderly patients that can help both predict prognosis and toxicity risk, 19 including an ASCO guideline on the assessment and management of vulnerabilities in older patients receiving chemotherapy 20 (Fig 3).…”

Section: Question: What Is the Optimal Second Or Later Line Systemic ...mentioning

confidence: 99%

Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline Q&A

Singer

Rumble

Veldhuizen

2023

JCO Oncology Practice

View full text Add to dashboard Cite

show abstract

Comprehensive geriatric assessment is an independent prognostic factor in older patients with metastatic renal cell cancer treated with first-line Sunitinib or Pazopanib: a single center experience

Cited by 12 publications

References 35 publications

Safety and Efficacy of Tivozanib in First-Line mRCC: A Multicenter Compassionate-Use Study (Meet-Uro 16)

Safety and Efficacy of Tivozanib in First-Line mRCC: A Multicenter Compassionate-Use Study (Meet-Uro 16)

Geriatric assessment in the older adult with genitourinary cancer: A narrative review

Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline Q&A

Contact Info

Product

Resources

About