Outcomes based on age in patients with metastatic renal cell carcinoma treated with first line targeted therapy or checkpoint immunotherapy: Older patients more prone to toxicity

Hermansen, Carina K.; Donskov, Frede

doi:10.1016/j.jgo.2020.12.008

Cited by 17 publications

(10 citation statements)

References 39 publications

(57 reference statements)

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“…This trend was observed with sunitinib or pazopanib in a retrospective analysis based on age in patients with metastatic RCC; patients aged ≥75 years received a lower dose of sunitinib or pazopanib. 25 …”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of avelumab plus axitinib in elderly patients with advanced renal cell carcinoma: extended follow-up results from JAVELIN Renal 101

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of avelumab plus axitinib in elderly patients with advanced renal cell carcinoma: extended follow-up results from JAVELIN Renal 101

et al. 2022

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“…Previous studies reported that an older age did not affect survival outcomes in mRCC [10][11][12] . However, this retrospective analysis revealed that OS and CSS were signi cantly shorter in mRCC patients ≥ 75 years, and that PFS after rst-and second-line therapies was not a surrogate for OS or CSS in mRCC patients ≥ 75 years.…”

Section: Discussionmentioning

confidence: 80%

Anemia in patients ≥75 years with metastatic clear cell renal cell carcinoma: An important poor prognostic factor in the international metastatic renal cell carcinoma database consortium model

Mizuno

Yasumizu

Tanaka

et al. 2023

Preprint

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Background Due to an increase in life expectancy, the incidence of metastatic renal cell carcinoma (mRCC) in patients aged ≥75 years has been increasing. In this study we investigated the characteristics before treatment and the outcomes of systemic therapies for patients aged ≥75 years with mRCC and compared the results with those for patients aged <75years in order to determine whether differences in age influenced survival. Methods A total of 206 consecutive Japanese patients with mRCC, including 47 patients aged ≥75 years, who received systemic therapy were included. Clinical data from medical records were retrieved and analyzed retrospectively. Survival analyses were determined using a Kaplan–Meier method, and analyzed with a log-rank test. Results Elderly patients categorized as favorable risk group based on the International Metastatic RCC Database Consortium (IMDC) stratification system were significantly lower. Among IMDC risk factors, the rate of anemia was significantly higher in elderly patients. No statistically significant benefit in progression free survival for first and second line treatment was observed, whereas improvements in overall survival as well as cancer specific survival were seen in patients aged <75 years. Conclusions For mRCC patients aged ≥75 years, a higher proportion of base line anemia, which resulted in higher rates of IMDC intermediate/poor risk, would be responsible for shorter OS/CSS. Furthermore, mRCC patients aged ≥75 years tend to receive BSC instead of second line active treatment. Overcoming under-treatment in elderly patients might help to prolong survival in mRCC.

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“…Baseline clinical characteristics of interest were defined a priori based on established associations with favorable OS or objective imaging response; these characteristics included IMDC risk group, 11 presence of sarcomatoid histological characteristics, 12 receipt of CN, 13 and sites of metastasis. 14 , 15 , 16 , 17 Although age 18 , 19 and sex 20 have not been reported to interact with outcomes associated with contemporary therapies for mRCC, these variables were included in the analysis because they had not been examined as confounders in large routine-practice data sets. In the adjusted logistic regression analysis, only CN (odds ratio [OR], 1.59; 95% CI, 1.04-2.43; P = .03), deferred nephrectomy (OR, 3.04; 95% CI, 1.03-8.97; P = .04), lung metastases (OR, 1.49; 95% CI, 1.01-2.20; P = .04), and favorable vs poor IMDC risk group (OR, 1.93; 95% CI, 1.10-3.39; P = .02) were associated with objective imaging response in a statistically significant and clinically meaningful manner ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Imaging Response to Contemporary Immuno-oncology Combination Therapies in Patients With Metastatic Renal Cell Carcinoma

et al. 2022

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Key Points Question Do contemporary first-line therapy options for metastatic renal cell carcinoma (mRCC) have different likelihoods of objective imaging response (complete or partial response), and is objective imaging response associated with overall survival? Findings In this cohort study involving 899 patients with mRCC, treatment with immune checkpoint blockade plus vascular endothelial growth factor receptor inhibitor combination therapies was more likely to be associated with objective imaging response than doublet immune checkpoint blockade therapy after adjustment for baseline demographic and clinical characteristics, including International Metastatic Renal Cell Carcinoma Database Consortium risk criteria. Objective imaging response was associated with improvement in overall survival among patients receiving both types of therapy. Meaning This study’s findings suggest that combination therapies with first-line immune checkpoint blockade plus vascular endothelial growth factor receptor inhibitor were more likely to be associated with objective imaging response than doublet immune checkpoint blockade therapy.

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Outcomes based on age in patients with metastatic renal cell carcinoma treated with first line targeted therapy or checkpoint immunotherapy: Older patients more prone to toxicity

Cited by 17 publications

References 39 publications

Efficacy and safety of avelumab plus axitinib in elderly patients with advanced renal cell carcinoma: extended follow-up results from JAVELIN Renal 101

Efficacy and safety of avelumab plus axitinib in elderly patients with advanced renal cell carcinoma: extended follow-up results from JAVELIN Renal 101

Anemia in patients ≥75 years with metastatic clear cell renal cell carcinoma: An important poor prognostic factor in the international metastatic renal cell carcinoma database consortium model

Imaging Response to Contemporary Immuno-oncology Combination Therapies in Patients With Metastatic Renal Cell Carcinoma

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