Ugo De Giorgi1, Emanuela Scarpi2, Cosimo Sacco3, Michele Aieta4, Giovanni Lo Re5, Teodoro Sava6, Cristina Masini7, Fabio De Vincenzo8, Valentina Baldazzi9, Andrea Camerini10, Giuseppe Fornarini11, Luciano Burattini12, Giovanni Rosti13, Vittorio Ferrari14, Luca Moscetti15, Vincenzo Emanuele Chiuri16, Stefano Luzi Fedeli17, Dino Amadori2, Umberto Basso18. 1. IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy. Electronic address: u.degiorgi@irst.emr.it. 2. IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy. 3. Santa Maria della Misericordia Hospital, Udine, Italy. 4. CROB, Rionero in Vulture, Italy. 5. Santa Maria degli Angeli Hospital, Pordenone, Italy. 6. Borgo Trento Hospital, Verona, Italy. 7. University Hospital, Modena, Italy. 8. Humanitas Hospital, Milano, Italy. 9. Oncologia 2 - AOU Careggi, Florence, Italy. 10. Versilia Hospital, Lido di Camaiore, Italy. 11. IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy. 12. University Hospital, Ancona, Italy. 13. Ca' Foncello Hospital, Treviso, Italy. 14. Spedali Civili, Brescia, Italy. 15. Belcolle Hospital, Viterbo, Italy. 16. Fazzi Hospital, Lecce, Italy. 17. San Salvatore Hospital, Pesaro, Italy. 18. Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy.
Abstract
BACKGROUND: There are no data on the patterns of care and outcome of elderly patients with mRCC treated with sunitinib. In a retrospective study, we assessed the routine use of first-line sunitinib in mRCC patients aged ≥ 70 years. PATIENTS AND METHODS: We reviewed the clinical files of 185 patients aged ≥ 70 years with mRCC treated with first-line sunitinib in 17 Italian oncology units from February 2006 to September 2011. One hundred twenty-three patients (66.5%) received a standard 50 mg/d for a 4 weeks on/2 weeks off regimen (SR), and 62 patients (33.5%) received an AR consisting of 37.5 mg/d for a 4 weeks on/2 weeks off in 67.7% of cases. RESULTS: Median age was 74 years. Patients treated with an AR were older than those treated with the SR (P < .0001). In the overall population, the median progression-free survival (PFS) was 11 months, and the median overall survival (OS) was 25.5 months. Grade 3-4 toxicities occurred in 87 of 123 SR (70.7%) and 32 of 62 AR (51.6%), respectively; dose reductions were required in 82 SR (66.7%) and 26 AR (41.9%), respectively; discontinuations because of therapy-related adverse events occurred in 25 SR (20.3%) and 15 AR (24.2%), respectively. In multivariate analysis, only performance status and the Heng score were predictors of either PFS or OS. CONCLUSION: Sunitinib is active and feasible in elderly patients with mRCC. A sunitinib AR could be considered as an option in selected older mRCC patients. The optimal treatment of frail patients with mRCC remains to be established.
BACKGROUND: There are no data on the patterns of care and outcome of elderly patients with mRCC treated with sunitinib. In a retrospective study, we assessed the routine use of first-line sunitinib in mRCC patients aged ≥ 70 years. PATIENTS AND METHODS: We reviewed the clinical files of 185 patients aged ≥ 70 years with mRCC treated with first-line sunitinib in 17 Italian oncology units from February 2006 to September 2011. One hundred twenty-three patients (66.5%) received a standard 50 mg/d for a 4 weeks on/2 weeks off regimen (SR), and 62 patients (33.5%) received an AR consisting of 37.5 mg/d for a 4 weeks on/2 weeks off in 67.7% of cases. RESULTS: Median age was 74 years. Patients treated with an AR were older than those treated with the SR (P < .0001). In the overall population, the median progression-free survival (PFS) was 11 months, and the median overall survival (OS) was 25.5 months. Grade 3-4 toxicities occurred in 87 of 123 SR (70.7%) and 32 of 62 AR (51.6%), respectively; dose reductions were required in 82 SR (66.7%) and 26 AR (41.9%), respectively; discontinuations because of therapy-related adverse events occurred in 25 SR (20.3%) and 15 AR (24.2%), respectively. In multivariate analysis, only performance status and the Heng score were predictors of either PFS or OS. CONCLUSION:Sunitinib is active and feasible in elderly patients with mRCC. A sunitinibAR could be considered as an option in selected older mRCC patients. The optimal treatment of frail patients with mRCC remains to be established.
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: Xuan Qiu; Manjiang Li; Liqun Wu; Yang Xin; Siyu Mu; Tianxiang Li; Kangjian Song Journal: Cancer Manag Res Date: 2020-09-04 Impact factor: 3.989