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Standard vs adapted sunitinib regimen in elderly patients with metastatic renal cell cancer: results from a large retrospective analysis.

Abstract：

BACKGROUND:There are no data on the patterns of care and outcome of elderly patients with mRCC treated with sunitinib. In a retrospective study, we assessed the routine use of first-line sunitinib in mRCC patients aged ≥ 70 years. PATIENTS AND METHODS:We reviewed the clinical files of 185 patients aged ≥ 70 years with mRCC treated with first-line sunitinib in 17 Italian oncology units from February 2006 to September 2011. One hundred twenty-three patients (66.5%) received a standard 50 mg/d for a 4 weeks on/2 weeks off regimen (SR), and 62 patients (33.5%) received an AR consisting of 37.5 mg/d for a 4 weeks on/2 weeks off in 67.7% of cases. RESULTS:Median age was 74 years. Patients treated with an AR were older than those treated with the SR (P < .0001). In the overall population, the median progression-free survival (PFS) was 11 months, and the median overall survival (OS) was 25.5 months. Grade 3-4 toxicities occurred in 87 of 123 SR (70.7%) and 32 of 62 AR (51.6%), respectively; dose reductions were required in 82 SR (66.7%) and 26 AR (41.9%), respectively; discontinuations because of therapy-related adverse events occurred in 25 SR (20.3%) and 15 AR (24.2%), respectively. In multivariate analysis, only performance status and the Heng score were predictors of either PFS or OS. CONCLUSION:Sunitinib is active and feasible in elderly patients with mRCC. A sunitinib AR could be considered as an option in selected older mRCC patients. The optimal treatment of frail patients with mRCC remains to be established.

journal_name

Clin Genitourin Cancer

journal_title

Clinical genitourinary cancer

authors

De Giorgi U,Scarpi E,Sacco C,Aieta M,Lo Re G,Sava T,Masini C,De Vincenzo F,Baldazzi V,Camerini A,Fornarini G,Burattini L,Rosti G,Ferrari V,Moscetti L,Chiuri VE,Luzi Fedeli S,Amadori D,Basso U

doi

10.1016/j.clgc.2013.11.005

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

182-9

issue

3

eissn

1558-7673

issn

1938-0682

pii

S1558-7673(13)00276-0

journal_volume

12

pub_type

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