BACKGROUND: Actual tolerability of sunitinib is still poorly documented in elderly patients with metastatic renal cell carcinoma (mRCC). PATIENTS AND METHODS: Charts of elderly patients treated with sunitinib for mRCC were reviewed in six Italian centers to assess safety (primary objective), efficacy and correlation of toxicity with comprehensive geriatric assessment (CGA) (secondary objectives). RESULTS: Sixty-eight patients were eligible, and the median age was 74 years. CGA was carried out in 34 patients (41% fit, 41% vulnerable and 18.5% frail). The dose reduction to 37.5 mg was made upfront or soon after the first cycle in 69.1%. More frequent toxic effects were fatigue (80.9%), mucositis (61.8%) and hypertension (58.8%). Cardiac events occurred in nine patients. In 10 patients, therapy was interrupted early due to rapidly progressive disease (10.3%) or severe toxicity (4.4%: 1 cardiac failure, 1 fatigue, 1 febrile neutropenia). At a median follow-up of 27.1 months, the median OS was 18.3 months and the median PFS was 13.6 months. Correlation was not found between frailty at CGA with severe toxicity nor with response. CONCLUSIONS: Treatment with sunitinib is effective in elderly patients; yet early interruptions were frequent. Starting treatment at reduced dose and escalating in the absence of severe toxicity could be suggested.
BACKGROUND: Actual tolerability of sunitinib is still poorly documented in elderly patients with metastatic renal cell carcinoma (mRCC). PATIENTS AND METHODS: Charts of elderly patients treated with sunitinib for mRCC were reviewed in six Italian centers to assess safety (primary objective), efficacy and correlation of toxicity with comprehensive geriatric assessment (CGA) (secondary objectives). RESULTS: Sixty-eight patients were eligible, and the median age was 74 years. CGA was carried out in 34 patients (41% fit, 41% vulnerable and 18.5% frail). The dose reduction to 37.5 mg was made upfront or soon after the first cycle in 69.1%. More frequent toxic effects were fatigue (80.9%), mucositis (61.8%) and hypertension (58.8%). Cardiac events occurred in nine patients. In 10 patients, therapy was interrupted early due to rapidly progressive disease (10.3%) or severe toxicity (4.4%: 1 cardiac failure, 1 fatigue, 1 febrile neutropenia). At a median follow-up of 27.1 months, the median OS was 18.3 months and the median PFS was 13.6 months. Correlation was not found between frailty at CGA with severe toxicity nor with response. CONCLUSIONS: Treatment with sunitinib is effective in elderly patients; yet early interruptions were frequent. Starting treatment at reduced dose and escalating in the absence of severe toxicity could be suggested.
Authors: Alexandr Poprach; Radek Lakomy; Zbynek Bortlicek; Bohuslav Melichar; Tomas Pavlik; Ondrej Slaby; Rostislav Vyzula; Marek Svoboda; Igor Kiss; Hana Studentova; Milada Zemanova; Ondrej Fiala; Katerina Kubackova; Ladislav Dusek; Jana Hornova; Tomas Buchler Journal: Drugs Aging Date: 2016-09 Impact factor: 3.923
Authors: Javier Puente; Xavier García Del Muro; Álvaro Pinto; Nuria Láinez; Emilio Esteban; José Ángel Arranz; Enrique Gallardo; María José Méndez; Pablo Maroto; Enrique Grande; Cristina Suárez Journal: Target Oncol Date: 2016-04 Impact factor: 4.493
Authors: Nicholas J Vogelzang; Sumanta K Pal; Sameer R Ghate; Elyse Swallow; Nanxin Li; Miranda Peeples; Miriam L Zichlin; Mark K Meiselbach; Jose Ricardo Perez; Neeraj Agarwal Journal: Adv Ther Date: 2017-10-26 Impact factor: 3.845