A Ravaud1. 1. Department of Medical Oncology and Radiotherapy, Hôpital Saint-Andre, University Hospital, Bordeaux and Université Bordeaux, 2 Victor Segalen, Bordeaux, France. alain.ravaud@chu-bordeaux.fr
Abstract
BACKGROUND: Targeted agents are being used increasingly for the treatment of metastatic renal cell carcinoma (mRCC). Targeted agents are associated with a distinct pattern of adverse events (AEs) in mRCC, which should be managed promptly to ensure that patients maintain tumour control without impacting quality of life. DESIGN: This article discusses the importance of maintaining patients on optimum doses of targeted therapy to maximise treatment benefit, and reviews the safety profiles of targeted agents in mRCC. Strategies for managing the AEs associated with targeted agents are presented. RESULTS: Higher exposure to targeted agents is positively associated with increased probability of achieving improved overall survival, underlining the importance of maintaining patients on appropriate doses to derive clinical benefit. Patients' risk profiles should be assessed before commencing targeted therapy and patients should be educated about AEs to aid early identification and treatment and improve compliance. Practical steps can be taken to minimise the impact of AEs and maintain patients on targeted therapy. CONCLUSIONS: Targeted agents are associated with predictable AE profiles in mRCC. Early detection of treatment-related AEs and effective implementation of management strategies can reduce patient discomfort, avoid the need for dose reductions and discontinuations, improve patient compliance and support optimal clinical outcomes.
BACKGROUND: Targeted agents are being used increasingly for the treatment of metastatic renal cell carcinoma (mRCC). Targeted agents are associated with a distinct pattern of adverse events (AEs) in mRCC, which should be managed promptly to ensure that patients maintain tumour control without impacting quality of life. DESIGN: This article discusses the importance of maintaining patients on optimum doses of targeted therapy to maximise treatment benefit, and reviews the safety profiles of targeted agents in mRCC. Strategies for managing the AEs associated with targeted agents are presented. RESULTS: Higher exposure to targeted agents is positively associated with increased probability of achieving improved overall survival, underlining the importance of maintaining patients on appropriate doses to derive clinical benefit. Patients' risk profiles should be assessed before commencing targeted therapy and patients should be educated about AEs to aid early identification and treatment and improve compliance. Practical steps can be taken to minimise the impact of AEs and maintain patients on targeted therapy. CONCLUSIONS: Targeted agents are associated with predictable AE profiles in mRCC. Early detection of treatment-related AEs and effective implementation of management strategies can reduce patient discomfort, avoid the need for dose reductions and discontinuations, improve patient compliance and support optimal clinical outcomes.
Authors: Gary R Hudes; Michael A Carducci; Toni K Choueiri; Peg Esper; Eric Jonasch; Rashmi Kumar; Kim A Margolin; M Dror Michaelson; Robert J Motzer; Roberto Pili; Susan Roethke; Sandy Srinivas Journal: J Natl Compr Canc Netw Date: 2011-02 Impact factor: 11.908