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.

Abstract:

OBJECTIVES:Older patients with metastatic renal cell carcinoma (mRCC) were underrepresented in pivotal trials. MATERIALS AND METHODS:Consecutive patients with mRCC treated at Aarhus University Hospital with first line tyrosine kinase inhibitors (TKI), mTOR inhibitors, or checkpoint immunotherapy (CPI) were retrospectively analyzed in age-subgroups; ≥ 75, 65-74, and < 65 years, with overall survival (OS), time-to-treatment discontinuation (TTD), and progression-free survival (PFS) as endpoints. Hazards ratios were adjusted (aHR) for International Metastatic RCC Database Consortium (IMDC) risk factors, histology, and age. RESULTS:Of 838 patients, 159 (19%) were ≥ 75 years, 324 (39%) 65-74 years, and 355 (42%) < 65 years. Treatments were TKI in 729 (87%) patients, mTOR in 43 (5%) and CPI in 67 (8%). Older patients ≥ 75 years compared with 65-74 years and < 65 years had lower toxicity-adjusted median doses of pazopanib, 300 mg vs. 400 mg vs. 600 mg, respectively, (p < 0.001), and sunitinib, 25 mg vs. 37.5 mg vs. 50 mg, respectively (p < 0.001); numerically fewer doses of CPI, median 2 vs. 5 vs. 5, respectively, (p = 0.2); a higher proportion had dose reduction/interruption, 76% vs. 55% vs. 41%, respectively, (p < 0.001); and shorter mean time to dose reduction/interruption, 0.5 months vs. 1.9 months vs. 3.4 months, respectively, (p < 0.001). After adjusting IMDC prognostic factors and histology in multivariate analyses, age did not impact OS (aHR 1.0; 95% CI 0.99-1.02, p = 0.2), TTD (aHR 1.0; 95% CI 0.99-1.01, p = 0.4) or PFS (aHR 1.0, 95% CI 0.99-1.01; p = 0.9). CONCLUSION:Older patients with mRCC were more prone to toxicity; but age did not impact outcomes. Proactive dose modification/interruption and awareness may help to reduce toxicity while maintaining efficacy.

journal_name

J Geriatr Oncol

authors

Hermansen CK,Donskov F

doi

10.1016/j.jgo.2020.12.008

subject

Has Abstract

pub_date

2020-12-31 00:00:00

eissn

1879-4068

issn

1879-4076

pii

S1879-4068(20)30530-0

pub_type

杂志文章
  • Association between a cognitive screening test and severe chemotherapy toxicity in older adults with cancer.

    abstract:INTRODUCTION:Cognitive impairment (CI) increases chemotherapy toxicity risk with need to understand this association utilizing publicly available short screening tools. We evaluated this utilizing a lower threshold on a short screening tool in older adults with cancer. MATERIALS AND METHODS:We analyzed data from the C...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2019.10.004

    authors: Jayani RV,Magnuson AM,Sun CL,Ma H,Tew WP,Mohile SG,Gajra A,Klepin HD,Gross CP,Muss HB,Chapman AE,Katheria V,Hurria A,Dale W

    更新日期:2020-03-01 00:00:00

  • Development and psychometric validation of a brief comprehensive health status assessment scale in older patients with hematological malignancies: The GAH Scale.

    abstract:OBJECTIVES:The purpose of this study was to develop a new brief, comprehensive geriatric assessment scale for older patients diagnosed with different hematological malignancies, the Geriatric Assessment in Hematology (GAH scale), and to determine its psychometric properties. MATERIALS AND METHODS:The 30-item GAH scale...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jgo.2015.03.003

    authors: Bonanad S,De la Rubia J,Gironella M,Pérez Persona E,González B,Fernández Lago C,Arnan M,Zudaire M,Hernández Rivas JA,Soler A,Marrero C,Olivier C,Altés A,Valcárcel D,Hernández MT,Oiartzabal I,Fernández Ordoño R,Arnao M,

    更新日期:2015-09-01 00:00:00

  • New Treatment Approaches for Older Adults with Multiple Myeloma.

    abstract::The incidence of multiple myeloma (MM) increases with age, and with the aging of the population, the number of adults with MM is expected to double in the next 20 years. Novel agents, including the immunomodulatory agents thalidomide and lenalidomide, and the proteosome inhibitor bortezomib have dramatically changed t...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2012.02.001

    authors: Wildes TM,Vij R,Petersdorf SH,Medeiros BC,Hurria A

    更新日期:2012-07-01 00:00:00

  • Detection of frailty in elderly cancer patients: Improvement of the G8 screening test.

    abstract:OBJECTIVE:The G8 is a screening test to identify frail elderly patients with cancer. Objectives were to design and evaluate the performance of alternative tests taking into account other predictive domains for frailty. METHODS:We conducted a literature review to identify predictive factors of frailty. Using a Delphi c...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2016.01.004

    authors: Petit-Monéger A,Rainfray M,Soubeyran P,Bellera CA,Mathoulin-Pélissier S

    更新日期:2016-03-01 00:00:00

  • Behavioral, psychological, and supportive care interventions in geriatric oncology: The Cancer and Aging Research Group infrastructure core.

    abstract::Current research efforts focusing on improving outcomes of older adults with cancer lack the appropriate infrastructure to support this growing need. The Cancer and Aging Group R21/33 National Institute of Health (NIH)/National Institute of Aging (NIA) grant aims to support development of geriatric oncology research t...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2019.07.019

    authors: Elias R,Loh KP,Targia V,Whitehead M,Canin B,Jatoi A,Loscalzo M,Mohile S

    更新日期:2020-03-01 00:00:00

  • Older survivors of cancer in the COVID-19 pandemic: Reflections and recommendations for future care.

    abstract:PURPOSE:Although the year after cancer treatment is challenging for all cancer survivors, older adults (≥60 years) face additional challenges due to age-related decline and high rates of comorbidity. There is a paucity of research on how health service interruptions from the COVID-19 pandemic have impacted the experien...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2020.11.009

    authors: Haase KR,Kain D,Merchant S,Booth C,Koven R,Brundage M,Galica J

    更新日期:2020-12-03 00:00:00

  • Age-related differences in persistence in women with breast cancer treated with tamoxifen or aromatase inhibitors in Germany.

    abstract:AIMS:To study age-related persistence in postmenopausal women with endocrine-responsive breast cancer treated with tamoxifen (TAM) and aromatase inhibitors (AI). METHODS:Data on 29,245 patients diagnosed with metastatic or non-metastatic breast cancer (BC) and initially treated with TAM or AI between 2004 and 2013 wer...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2016.03.001

    authors: Jacob L,Hadji P,Kostev K

    更新日期:2016-05-01 00:00:00

  • Poor patient health is associated with higher caregiver burden for older adults with advanced cancer.

    abstract:OBJECTIVES:Family caregiver burden among older adults with advanced cancer remains poorly understood. We sought to (1) identify patient factors associated with caregiver burden and (2) examine how amount of time caregiving modifies these relationships. METHODS:Cross-sectional analysis of baseline data from a cluster-r...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2021.01.002

    authors: Semere W,Althouse AD,Rosland AM,White D,Arnold R,Chu E,Smith TJ,Schenker Y

    更新日期:2021-01-18 00:00:00

  • Patient Characteristics Associated with Polypharmacy and Inappropriate Prescribing of Medications among Older Adults with Cancer.

    abstract::OBJECTIVES: To identify patient characteristics associated with polypharmacy and inappropriate medication (PIM) use among older patients with newly diagnosed cancer. DESIGN: Cross-Sectional Study. SETTING: Ambulatory oncology clinics at an academic medical center. PARTICIPANTS: 117 patients aged ≥ 65 years with new...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2012.02.005

    authors: Prithviraj GK,Koroukian S,Margevicius S,Berger NA,Bagai R,Owusu C

    更新日期:2012-07-01 00:00:00

  • Low levels of intra-tumoural T cells in breast cancer identify clinically frail patients with shorter disease-specific survival.

    abstract:OBJECTIVES:The global health status of older patients with cancer influences their clinical course, but little is known regarding the influence of the immune system on the global health of older patients with cancer. The goal of this study was to assess the relationships between patient fitness/frailty status and survi...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jgo.2018.03.021

    authors: Speigl L,Grieb A,Janssen N,Hatse S,Brouwers B,Smeets A,Floris G,Bailur JK,Kenis C,Neven P,Wildiers H,Pawelec G,Shipp C

    更新日期:2018-11-01 00:00:00

  • Treatment strategies and survival outcomes in older women with breast cancer: A comparative study between the FOCUS cohort and Nottingham cohort.

    abstract:OBJECTIVE:Clinical trials investigating breast cancer treatment often exclude or misrepresent older adults. This study compares treatment patterns and survival of older women diagnosed with breast cancer between a Dutch and a British observational cohort. MATERIALS AND METHODS:Women aged 70 years and older diagnosed w...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2018.05.004

    authors: Schuil H,Derks M,Liefers GJ,Portielje J,van de Velde C,Syed B,Green A,Ellis I,Cheung KL,Bastiaannet E

    更新日期:2018-11-01 00:00:00

  • Effect of advanced age on peri-operative outcomes after robotic-assisted pulmonary lobectomy: Retrospective analysis of 287 consecutive cases.

    abstract:OBJECTIVES:We investigated whether advanced age affects peri-operative outcomes after robotic-assisted pulmonary lobectomies. MATERIALS AND METHODS:We retrospectively analyzed patients who underwent robotic-assisted lobectomy by one surgeon over a 5-year period. Rates of postoperative complications were compared accor...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2016.11.003

    authors: Kass KS,Velez-Cubian FO,Zhang WW,Toosi K,Tanvetyanon T,Rodriguez KL,Thau MR,Garrett JR,Moodie CC,Fontaine JP,Toloza EM

    更新日期:2017-03-01 00:00:00

  • Implementing and validating a care protocol for older adults with cancer in resource limited settings with a newly developed screening tool.

    abstract:BACKGROUND:Cancer in the aging population presents manifold challenges. In the resource-limited settings of developing countries, concrete steps to optimize care for older adults with cancer are required. MATERIALS AND METHOD:This prospective, observational study was divided in two parts. In the first part, older adul...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2020.04.013

    authors: Banerjee J,Behal P,Satapathy S,Kandel R,Upadhyay AD,Dwivedi S,Kumar L,Dey AB

    更新日期:2021-01-01 00:00:00

  • Omission of axillary staging in elderly patients with early stage breast cancer impacts regional control but not survival: A systematic review and meta-analysis.

    abstract:INTRODUCTION:Management of early breast cancer in the elderly population is challenging due to different breast cancer biology and limited tolerance to aggressive treatments. The aim of this study is to evaluate whether the omission of axillary staging impacts breast cancer outcomes in elderly patients. PATIENTS AND M...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1016/j.jgo.2016.12.003

    authors: Liang S,Hallet J,Simpson JS,Tricco AC,Scheer AS

    更新日期:2017-03-01 00:00:00

  • Validity of Adjuvant! Online in older patients with stage III colon cancer based on 2967 patients from the ACCENT database.

    abstract:BACKGROUND:Adjuvant! Online is a tool used for clinical decision making in patients with early stage colon cancer. As details of the tool's construction are not published, the ability of Adjuvant! Online to accurately predict outcomes for older patients (age 70+) with node positive colon cancer receiving adjuvant chemo...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2016.07.002

    authors: Papamichael D,Renfro LA,Matthaiou C,Yothers G,Saltz L,Guthrie KA,Van Cutsem E,Schmoll HJ,Labianca R,André T,O'Connell M,Alberts SR,Haller DG,Kountourakis P,Sargent DJ,Adjuvant Colon Cancer Endpoints (ACCENT) Group.

    更新日期:2016-11-01 00:00:00

  • The impact of changes in radiographic sarcopenia on overall survival in older adults undergoing different treatment pathways for pancreatic cancer.

    abstract:OBJECTIVE:Sarcopenia is associated with poor outcomes in patients undergoing surgery for pancreatic ductal adenocarcinoma (PDAC). However, few studies have assessed changes in sarcopenia during multimodality therapy or its effect on overall survival (OS). METHODS:Computed tomography (CT) total psoas area index (TPAI) ...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2018.03.002

    authors: Benjamin AJ,Buschmann MM,Zhang SQ,Wroblewski K,Kindler HL,Roggin KK,Dale W

    更新日期:2018-07-01 00:00:00

  • Activities, function, and health-related quality of life (HRQOL) of older adults with cancer.

    abstract:OBJECTIVE:This study aims to (1) describe the activities, function, and health-related quality of life (HRQOL) of a large sample of older adults (age ≥65) with cancer, (2) identify the associations with demographics, cancer type, comorbid conditions, and ability to participate in activities and functional status. MATE...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2017.02.009

    authors: Pergolotti M,Deal AM,Williams GR,Bryant AL,Bensen JT,Muss HB,Reeve BB

    更新日期:2017-07-01 00:00:00

  • Optimal management of localized rectal cancer in older patients.

    abstract::In advising the optimal management for older patients, health care professionals try to balance the risks from frailty, vulnerability, and comorbidity against the patient's ultimate prognosis, potential functional outcomes and quality of life (QOL). At the same time it is important to involve the patient and incorpora...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章,评审

    doi:10.1016/j.jgo.2018.08.001

    authors: Bujko K,Glynne-Jones R,Papamichael D,Rutten HJT

    更新日期:2018-11-01 00:00:00

  • Patient-reported and objectively measured physical function in older breast cancer survivors and cancer-free controls.

    abstract:OBJECTIVES:Older breast cancer survivors (BCS) consistently report more functional limitations than women without cancer, but whether or not these differences remain when using objective measures of physical functioning and the correlates of these measures is unknown. METHODS:Cross-sectional study comparing older (≥60...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2018.10.006

    authors: Winters-Stone KM,Medysky ME,Savin MA

    更新日期:2019-03-01 00:00:00

  • Impact of age on treatment trends and clinical outcome in patients with metastatic renal cell carcinoma.

    abstract:OBJECTIVES:Clinical outcomes in older adults with metastatic renal cell carcinoma (mRCC) are poorly understood, particularly in the era of targeted therapies. We characterize survival and relevant treatment-related variables in a modern series. MATERIALS AND METHODS:From an institutional database including 562 patient...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2012.11.001

    authors: Pal SK,Hsu J,Hsu S,Hu J,Bergerot P,Carmichael C,Saikia J,Liu X,Lau C,Twardowski P,Figlin RA,Yuh BF

    更新日期:2013-04-01 00:00:00

  • Management of primary metastatic breast cancer in elderly patients--an international comparison of oncogeriatric versus standard care.

    abstract:BACKGROUND:An oncogeriatric approach may affect management of elderly patients with breast cancer. However, little is known about oncogeriatric care in the metastatic setting. Therefore, we performed an international comparison of management of elderly patients with primary metastatic disease who were treated in two di...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jgo.2014.02.005

    authors: van de Water W,Bastiaannet E,Egan KM,de Craen AJ,Westendorp RG,Balducci L,van de Velde CJ,Liefers GJ,Extermann M

    更新日期:2014-07-01 00:00:00

  • The acceleration of ageing in older patients with cancer.

    abstract::Older cancer survivors may experience ageing at an accelerated rate when compared to their similar-aged, cancer-free counterparts. Ageing is undoubtedly a significant risk factor for cancer. There is evidence to suggest, however, that this relationship may in fact be bidirectional, with cancer and its treatments contr...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章,评审

    doi:10.1016/j.jgo.2020.09.010

    authors: Muhandiramge J,Orchard S,Haydon A,Zalcberg J

    更新日期:2020-09-12 00:00:00

  • Aromatase inhibitors: The unexpected breast cancer treatment.

    abstract:OBJECTIVE:Suboptimal adherence with endocrine treatment for breast cancer is influenced by a number of factors but remains poorly understood. We sought to describe the prior knowledge about and expectations of breast cancer treatments among older women retrospecting on their diagnosis and treatment. METHODS:Thematic a...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2019.07.024

    authors: Pieters HC,Green E,Sleven M,Stanton AL

    更新日期:2020-04-01 00:00:00

  • Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy.

    abstract:INTRODUCTION:In general, geriatric assessment (GA) provides the combined information on comorbidity and functional, nutritional and psychosocial status and may be predictive for mortality outcome of cancer patients. The impact of geriatric assessment on the outcome of older patients with colorectal cancer treated with ...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2013.04.001

    authors: Aaldriks AA,van der Geest LG,Giltay EJ,le Cessie S,Portielje JE,Tanis BC,Nortier JW,Maartense E

    更新日期:2013-07-01 00:00:00

  • Surgical management of metastatic colon cancer: A population-based analysis.

    abstract:BACKGROUND:Metastasectomy has a curative potential in colon cancer, but its benefits have not been ascertained in population data. Our objective was to evaluate utilization of metastasectomy in colon cancer and its survival outcomes in groups defined by different age at diagnosis, tumor grade or varying extent of nodal...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2015.08.002

    authors: Khan H,Khan N,Ahmad A,Olszewski AJ,Somasundar P

    更新日期:2015-11-01 00:00:00

  • Sociodemographic, socioeconomic, and clinical determinants of survival in patients with cancer: A systematic review of the literature focused on the elderly.

    abstract::Studies on cancer survival have revealed disparities not only between the elderly and their younger counterparts, but also among the elderly themselves. The aim of this work was to identify sociodemographic, socioeconomic, clinical, and care-related determinants of survival or mortality in older patients with cancer b...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2017.07.007

    authors: Galvin A,Delva F,Helmer C,Rainfray M,Bellera C,Rondeau V,Soubeyran P,Coureau G,Mathoulin-Pélissier S

    更新日期:2018-01-01 00:00:00

  • Risk stratification for surgical outcomes in older colorectal cancer patients using ISAR-HP and G8 screening tools.

    abstract:BACKGROUND:Older patients are at risk for adverse outcomes after surgical treatment of cancer. Identifying patients at risk could affect treatment decisions and prevent functional decline. Screening tools are available to select patients for Geriatric Assessment. Until now their predictive value for adverse outcomes in...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jgo.2017.09.003

    authors: Souwer ETD,Verweij NM,van den Bos F,Bastiaannet E,Slangen RME,Steup WH,Hamaker ME,Portielje JEA

    更新日期:2018-03-01 00:00:00

  • Inflammatory biomarkers, geriatric assessment, and treatment outcomes in acute myeloid leukemia.

    abstract:OBJECTIVES:To investigate changes in inflammatory biomarkers during induction therapy for older adults with acute myeloid leukemia (AML) and their associations with geriatric assessment (GA) measures and outcomes. METHODS:This was a single institution ancillary study to a prospective observational study (N = 20 consec...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2019.03.014

    authors: Loh KP,Tooze JA,Nicklas BJ,Kritchevsky SB,Williamson JD,Ellis LR,Powell BL,Pardee TS,Goyal NG,Klepin HD

    更新日期:2020-04-01 00:00:00

  • Benefits of minimally-invasive surgery for sigmoid and rectal cancer in older adults compared with younger adults: Do older adults have the most to gain?

    abstract:INTRODUCTION:Randomized trials demonstrated oncologic safety and short-term benefits of laparoscopy. We investigated if the benefit of laparoscopy on short-term outcomes is greater for older adults compared with younger adults. METHODS:We identified all older (≥70 years old) and younger (<70) adults with primary sigmo...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2019.09.018

    authors: Chesney TR,Quereshy HA,Draginov A,Chadi SA,Quereshy FA

    更新日期:2020-06-01 00:00:00

  • Patterns of care and treatment outcomes in patients age 80 or older with non-metastatic pancreatic cancer.

    abstract:INTRODUCTION:Older adults are underrepresented in landmark trials that determine treatment guidelines for pancreatic cancer. We used the National Cancer Database (NCDB) to compare treatment patterns and outcomes in stage I-III pancreatic cancer between older adult patients, defined as age 80 or older, to patients young...

    journal_title:Journal of geriatric oncology

    pub_type: 杂志文章

    doi:10.1016/j.jgo.2019.12.006

    authors: Li R,Vazquez J,Novak J,Sedrak M,Warner S,Glaser S,Chen YJ,Dale W,Amini A

    更新日期:2020-05-01 00:00:00