Treatment patterns in metastatic renal cell carcinoma: a retrospective review of medical records from US community oncology practices

Abstract

Vol. 30, No. 10, 2014, 2041-2050

Patterns of care among patients receiving sequential targeted therapies for advanced renal cell carcinoma: A retrospective chart review in the USA

“…This study builds on and adds to earlier descriptions of treatment patterns, which included much smaller numbers of patients receiving recently approved treatments. 11,[19][20][21][22][23][24] The results of the present study showed that, at initiation of the second targeted therapy, patients' characteristics differed across treatments. In particular, lung metastases were observed more frequently in patients treated with everolimus and axitinib than in patients treated with sorafenib or sunitinib.…”

“…Consistent with our previous treatment pattern study conducted in 2012, sunitinib remained the most frequently used first targeted therapy, whereas everolimus remained the most frequently used second targeted therapy. 11 Furthermore, the use of pazopanib as first targeted therapy and of axitinib and sorafenib as second targeted therapies increased over time. A recent phase III trial (AXIS) has shown that, although axitinib is associated with longer progression-free survival than sorafenib, the overall survival results are comparable.…”

“…7,9,10 However, within a year of starting a first targeted therapy, most patients develop resistance to treatment and receive a second and, often, a third targeted therapy. 5,8,[11][12][13][14][15] Thus, deciding which targeted therapies should be used after failure of the first one -and in which sequence -amid a growing number of treatment options is a challenge. 10,16 Current NCCN guidelines recommend the use of VEGFR TKIs as first targeted therapy in patients with good-to-intermediate prognosis and the use of temsirolimus in patients with poor prognosis.…”

“…For this reason, several studies have been carried out to assess real-world treatment patterns. 11,[19][20][21][22][23][24] However, current treatment patterns, reflecting the adoption of newer treatments such as pazopanib (approved in October 2009) and axitinib (approved in March 2012), are not adequately captured by these studies based on older data. Because prescription habits are likely to change as physicians become more familiar with newer therapies, it is important to monitor how treatment patterns evolve over time to provide healthcare stakeholders with evidence from current real-world practice that can complement clinical trial data and inform clinical decision-making.…”

“…To identify changes in treatment patterns over time, the use of various first and second targeted therapies in the present study were descriptively compared with those previously reported by the same authors in a similarly designed study conducted in 2012. 11 …”