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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 patients with RCC, a total of 219 patients with metastatic disease were identified for the current analysis. Survival was assessed in four age-based cohorts: (1) age<55, (2) age 55–64, (3) age 65–74, and(4) age≥75. The number of lines of therapy rendered was collected for each patient, and the reason for treatment discontinuation was characterized. RESULTS:Of the 219 patients assessed, median age was 58 (range, 26–87), and most patients had clear cell histology (82%) and prior nephrectomy (70.9%). The majority of patients were characterized as intermediate-risk (53%) by MSKCC criteria. Median survival in patients age≥75 was 12.5 months, as compared to 26.4 months for patients age<75 (P=0.003). Patients age≥75 received fewer lines of systemic therapy as compared to other age-based subsets, and more frequently discontinued therapies due to toxicity. CONCLUSIONS:Older adults represent a unique subpopulation of patients with mRCC, with distinct clinical outcomes. Further research is warranted to better understand the safety and tolerability of current therapies for mRCC in this group.

journal_name

J Geriatr Oncol

journal_title

Journal of geriatric oncology

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

doi

10.1016/j.jgo.2012.11.001

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

128-33

issue

2

eissn

1879-4068

issn

1879-4076

pii

S1879-4068(12)00432-8

journal_volume

4

pub_type

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