Abstract:
INTRODUCTION/BACKGROUND:Targeted therapy has become the mainstay of treatment for mRCC. The efficacy of this therapy in the older population is poorly understood. PATIENTS AND METHODS:Data from patients with mRCC treated with first-line anti-VEGF therapy were collected through the International mRCC Database Consortium from 12 centers. Patient characteristics, data on second-line therapy, and outcomes including treatment duration and overall survival, were evaluated using summary statistics and multivariate analysis. RESULTS:All patients (n = 1381) were treated with front-line targeted therapy; 144 (10%) were 75 years old or older. Six patients (4%) were favorable risk, 99 patients (69%) intermediate risk, and 39 patients (27%) poor risk according to Heng Journal of Clinical Oncology 2009 prognostic factors. The initial treatment for those ≥ 75 years of age was sunitinib (n = 98), sorafenib (n = 35), bevacizumab (n = 7), and AZD217 (n = 4). Twenty-three percent of older patients and 39% of the younger patients went on to receive second-line therapy (P < .0001). The overall response rate, median treatment duration, and overall survival for the older versus younger group were 18% versus 25% (P = .0975), 5.5 months versus 7.5 months (P = .1388), and 16.8 months versus 19.7 months (P = .3321), respectively. When adjusted for poor prognostic factors, age 75 years and older was not found to be associated with poorer overall survival (hazard ratio [HR], 1.002; 95% confidence interval [CI], 0.781-1.285) or shorter treatment duration (HR, 1.018; 95% CI, 0.827-1.252). The retrospective study design was the primary limitation. CONCLUSION:The use of advanced age as a selection criterion for targeted therapy requires further study, with data suggesting no clinically meaningful differences in overall response rate, treatment duration, and overall survival between older and younger age groups.
journal_name
Clin Genitourin Cancerjournal_title
Clinical genitourinary cancerauthors
Khambati HK,Choueiri TK,Kollmannsberger CK,North S,Bjarnason GA,Vaishampayan UN,Wood L,Knox JJ,Tan MH,MacKenzie MJ,Donskov F,Rini BI,Heng DY,International mRCC Database Consortium.doi
10.1016/j.clgc.2014.02.009subject
Has Abstractpub_date
2014-10-01 00:00:00pages
354-8issue
5eissn
1558-7673issn
1938-0682pii
S1558-7673(14)00042-1journal_volume
12pub_type
杂志文章abstract:BACKGROUND:In recent years, new-onset hypothyroidism was extensively reported in patients receiving sunitinib for malignancy. Effects of sunitinib on serum lipids are not described, however a hyperlipidemic state is commonly observed in hypothyroid patients. Here we report about the incidence and severity of hyperchole...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.08.009
更新日期:2015-04-01 00:00:00
abstract:PURPOSE:To quantify the prognostic effect of the location of prostate cancer (PCa) metastases on cancer-specific mortality (CSM) and the rate of other-cause mortality (OCM) in contemporary newly diagnosed metastatic PCa (mPCa) patients. PATIENTS AND METHODS:Within the Surveillance Epidemiology and End Results database...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2018.05.016
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:In the phase III axitinib second-line (AXIS) trial, axitinib significantly prolonged progression-free survival (PFS) versus sorafenib in patients with previously treated metastatic renal cell carcinoma (mRCC). Analyses of associations between germline single-nucleotide polymorphisms (SNPs) and outcomes are r...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.clgc.2015.02.007
更新日期:2015-08-01 00:00:00
abstract:UNLABELLED:To identify the effects of diagnostic ureteroscopy on intravesical recurrence, 104 patients who had undergone radical nephroureterectomy were analyzed. The number of patients with intravesical recurrence was 34 (32.6%) at a mean of 37 months. Multivariate Cox model analysis revealed that delayed nephroureter...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.07.008
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The complete remission (CR) rate with salvage systemic therapy for urothelial carcinoma (UC) is unclear, and its value as an intermediate end point and association with survival are unknown. MATERIALS AND METHODS:Data from phase II trials of salvage chemotherapy and/or biologic agents were pooled. Data rega...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.09.004
更新日期:2015-04-01 00:00:00
abstract::Testicular germ cell tumors (TGCTs) represent the most common solid tumors among men aged 15 to 34 years. Fortunately, recent advances have made testicular cancer a highly curable disease. Despite the high cure rates, there are still several areas in testis cancer care where treatment decisions are controversial and g...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2018.10.007
更新日期:2019-02-01 00:00:00
abstract::Nephron-sparing surgery (NSS) for renal cell carcinoma (RCC) offers comparable oncologic results but a lower risk of chronic kidney disease when compared with radical nephrectomy; however it can result in positive surgical margins (PSMs) and consequently to a possible risk of oncologic failure. The aim of this review ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2012.09.010
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Upper urinary tract urothelial carcinoma (UUTUC) is one of the uncommon malignancies lacking of prognostic indicators. Lactate dehydrogenase (LDH) has been demonstrated to correlate with clinical outcomes in human cancers. In this study, we aimed to evaluate the prognostic implication of the preoperative LDH...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.01.003
更新日期:2016-08-01 00:00:00
abstract:INTRODUCTION:Tumor stage and grade represent the best established predictors for the prognosis of upper tract urothelial carcinoma (UTUC). However, controversies still exist regarding the role of tumor necrosis, location, and multifocality in the prognosis of UTUC. We share our experience with 305 patients, reporting o...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.04.017
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Cabozantinib showed efficacy and manageable toxicity in patients with metastatic renal cell carcinoma (mRCC). In this study we aimed to describe the safety and to collect evidence on the potential efficacy of cabozantinib in mRCC patients with brain metastases (BM) in a real-world experience. MATERIALS AND ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.05.002
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Limited information is available about the effect of bleomycin administration on the development of pulmonary toxicity in metastatic germ cell tumors (GCT). PATIENTS AND METHODS:A literature search was conducted to identify randomized trials of first-line chemotherapy for GCT. We conducted univariate and mu...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,meta分析
doi:10.1016/j.clgc.2016.08.021
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Carcinoma of the collecting ducts (CDC) of Bellini of the kidney is very rare but is among the most aggressive urologic entities. PATIENTS AND METHODS:Radical nephrectomy revealed CDC in stage pT3a pN2 M0 G3 in 2 male patients. Four courses of adjuvant chemotherapy with cisplatin and gemcitabine were given....
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2009.n.010
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Neoadjuvant radiotherapy (NART) for muscle-invasive bladder cancer (MIBC) is currently underused. However, the outcomes for MIBC have remained suboptimal. We investigated the relationship of NART to cause-specific mortality (CSM) and overall mortality (OM) among patients with a diagnosis of MIBC. MATERIALS ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.02.014
更新日期:2015-08-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to identify factors that are associated with quality of life (QoL) in relapse-free patients after radical prostatectomy or high-dose radiotherapy with or without hormone treatment. PATIENTS AND METHODS:A cross-sectional postal survey among members of the Norwegian Prostate Ca...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.07.004
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:Circulating tumor cells (CTCs) have great potential as circulating biomarkers for solid malignancies. Currently available assays for CTC detection rely on epithelial markers with somewhat limited sensitivity and specificity. We found that the staining pattern of nucleolin, a common nucleolar protein in pro...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.12.004
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Non-muscle-invasive bladder cancer (NMIBC) can be treated using transurethral resection (TUR), but high incidence of intravesical recurrence remains a clinical challenge. Single immediate postoperative instillation of chemotherapy (IPIOC) is controversial for NMIBC patients with intermediate recurrence risk....
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.05.028
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:In this study we aimed to determine the relationship between prostate-specific antigen (PSA)-related information obtained from the provider and PSA test uptake. With recent focus on patient-provider communication (PC) and the guidelines recommending against PSA tests for prostate cancer (PCa), PC regarding t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.05.002
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:The objective of this study was to examine the overall survival (OS) in patients diagnosed with high-grade T1 non-muscle-invasive bladder cancer treated with early radical cystectomy versus local treatment of the primary tumor, defined as endoscopic management with or without intravesical chemotherapy or i...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2020.03.013
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:To determine the therapeutic value of lymph node dissection (LND) during cytoreductive nephrectomy (CN) and assess predictors of cancer-specific survival (CSS) in metastatic renal-cell carcinoma. PATIENTS AND METHODS:We identified 293 consecutive patients treated with CN at 4 academic institutions from March 2...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2017.10.004
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Among men with high-risk non-metastatic castrate-resistant prostate cancer (nmCRPC), we used network meta-analysis to compare non-steroidal anti-androgens (NSAAs) and stratified class-level meta-analysis to identify subgroups with particular benefit from NSAAs with androgen deprivation therapy versus androge...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2020.02.005
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Sunitinib malate, a targeted tyrosine kinase inhibitor, is standard of care for metastatic renal cell carcinoma (mRCC) and serves as the active comparator in several ongoing mRCC clinical trials. In this analysis we report benchmarks for clinical outcomes on the basis of International Metastatic Renal Cell C...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.clgc.2018.04.005
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:The role of chemotherapy in nodal metastases from penile squamous cell carcinoma is not defined. We evaluated the efficacy of a combination of T-PF (a taxane, cisplatin, and 5-fluorouracil) in neoadjuvant and adjuvant settings. PATIENTS AND METHODS:Since June of 2004, T-PF was administered to stage N2 to 3 ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.07.009
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Nonurothelial carcinoma (UC) malignancies have traditionally been considered to have a more aggressive clinical course, and little is known about their response to neoadjuvant therapy. We examined the effect of neoadjuvant chemotherapy (NAC) on a large population of patients with bladder cancer (BCa) with di...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2020.01.007
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Oxidative stress has been found to be associated with the progression of prostate cancer (PCa); however, human studies which identify differential roles of each oxidation pathway in PCa progression are lacking. We aimed to identify which oxidative stress markers, specifically lipid and global oxidation and...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.09.014
更新日期:2020-04-01 00:00:00
abstract:PURPOSE:To determine a subset of women who could undergo ovary-sparing radical cystectomy (OSRC) for bladder cancer without compromising oncologic safety. PATIENTS AND METHODS:A retrospective review was performed of 164 consecutive women who underwent cystectomy at a single tertiary-care center from 1997 to 2018. Clin...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2018.10.009
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:There is a lack of molecularly-informed biomarkers for patients with metastatic renal cell carcinoma (RCC). Plasma cell-free DNA (cfDNA) sequencing is a minimally-invasive alternative to tissue for profiling the genome in other cancers but relevance in metastatic RCC remains unclear. MATERIALS AND METHODS:W...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.12.018
更新日期:2020-08-01 00:00:00
abstract::The use of sunitinib in dialysis patients is poorly described but is of clinical importance. We report 2 cases of patients receiving sunitinib for metastatic renal cell carcinoma while undergoing dialysis. The first patient is undergoing hemodialysis and, though responding to sunitinib, is having significant fatigue a...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2009.n.035
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:The programmed death-1 (PD-1) pathway negatively regulates T-cell activation and has an important role in regulating antitumor host immunity. Monoclonal antibodies directed against PD-1 or the PD-1 ligand (PD-L1) have shown activity in several tumor types with preliminary data suggesting a relationship betwe...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.12.002
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Myalgia and arthralgia immune-related adverse events (irAEs) in patients treated with checkpoint inhibitors (CPIs) present a clinical challenge. We describe the clinical characteristics and treatment of myalgia and arthralgia irAEs in CPI-treated patients with genitourinary (GU) malignancies. PATIENTS AND M...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.01.021
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Several agents have demonstrated an overall survival (OS) benefit in patients with metastatic castration-resistant prostate cancer (mCRPC); however, the optimal sequencing of these therapies is unknown as a result of a lack of prospective randomized controlled trials. This retrospective study aimed to identi...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2018.02.016
更新日期:2018-08-01 00:00:00