Nicholas J Vogelzang1, Michelle D Hackshaw2, Thomas E Hutson3, Debajyoti Bhowmik4, Mark Yap4, Debra Rembert4, Eric Jonasch5. 1. US Oncology Network, McKesson Specialty Health, The Woodlands, TX; Comprehensive Cancer Centers of Nevada, Las Vegas, NV. Electronic address: Nicholas.Vogelzang@usoncology.com. 2. GlaxoSmithKline, Collegeville, PA. 3. US Oncology Network, McKesson Specialty Health, The Woodlands, TX; Texas Oncology-Baylor Sammons Cancer Center, Dallas, TX. 4. US Oncology Network, McKesson Specialty Health, The Woodlands, TX. 5. University of Texas MD Anderson Cancer Center, Houston, TX.
Abstract
BACKGROUND: Clinical trials have demonstrated that pazopanib prolongs progression-free survival (PFS), with an acceptable safety profile, for patients with advanced renal cell carcinoma (aRCC). The efficacy of second-line mammalian target of rapamycin (mTOR) inhibitors in pazopanib-treated patients has also been evaluated in clinical trials; however, few studies have evaluated first-line pazopanib or second-line mTOR inhibitors in real-world settings. The present study evaluated the outcomes of first-line pazopanib, and pazopanib followed by mTOR inhibitors, in a community oncology setting. PATIENTS AND METHODS: The present study was a retrospective analysis of eligible patients in US Oncology's iKnowMed electronic health records database who had been treated for aRCC from November 1, 2009 to August 31, 2012. The patients received first-line therapy with pazopanib (cohort 1), followed by second-line therapy with either everolimus or temsirolimus (cohort 2). The key outcomes included overall survival (OS), PFS, adverse events (AEs), treatment patterns, and healthcare resource use. RESULTS: The median OS in cohort 1 (n = 177) was 22 months, and the median PFS was 8.5 months. The most common AEs were fatigue (56%), diarrhea (52%), vomiting (44%), and nausea (40%). The median persistence was 151 days with pazopanib. The median OS in cohort 2 (n = 35) was 16 months; the median PFS was 5.7 months. The most common AEs were fatigue (51%) and nausea (34%). The median persistence was 93 days with everolimus and 49 days with temsirolimus. CONCLUSION: The outcomes for the patients treated with first-line pazopanib in the community setting were consistent with those reported by previous prospective and retrospective studies. Although the second-line cohort was small, the results of mTOR inhibitors after pazopanib were also consistent with those of previous observations.
BACKGROUND: Clinical trials have demonstrated that pazopanib prolongs progression-free survival (PFS), with an acceptable safety profile, for patients with advanced renal cell carcinoma (aRCC). The efficacy of second-line mammalian target of rapamycin (mTOR) inhibitors in pazopanib-treated patients has also been evaluated in clinical trials; however, few studies have evaluated first-line pazopanib or second-line mTOR inhibitors in real-world settings. The present study evaluated the outcomes of first-line pazopanib, and pazopanib followed by mTOR inhibitors, in a community oncology setting. PATIENTS AND METHODS: The present study was a retrospective analysis of eligible patients in US Oncology's iKnowMed electronic health records database who had been treated for aRCC from November 1, 2009 to August 31, 2012. The patients received first-line therapy with pazopanib (cohort 1), followed by second-line therapy with either everolimus or temsirolimus (cohort 2). The key outcomes included overall survival (OS), PFS, adverse events (AEs), treatment patterns, and healthcare resource use. RESULTS: The median OS in cohort 1 (n = 177) was 22 months, and the median PFS was 8.5 months. The most common AEs were fatigue (56%), diarrhea (52%), vomiting (44%), and nausea (40%). The median persistence was 151 days with pazopanib. The median OS in cohort 2 (n = 35) was 16 months; the median PFS was 5.7 months. The most common AEs were fatigue (51%) and nausea (34%). The median persistence was 93 days with everolimus and 49 days with temsirolimus. CONCLUSION: The outcomes for the patients treated with first-line pazopanib in the community setting were consistent with those reported by previous prospective and retrospective studies. Although the second-line cohort was small, the results of mTOR inhibitors after pazopanib were also consistent with those of previous observations.
Authors: Marc R Matrana; Tharakeswara Bathala; Matthew T Campbell; Cihan Duran; Aditya Shetty; Purnima Teegavarapu; Sarathi Kalra; Lianchun Xiao; Bradley Atkinson; Paul Corn; Eric Jonasch; Nizar M Tannir Journal: BJU Int Date: 2015-12-13 Impact factor: 5.588
Authors: S Nazha; S Tanguay; A Kapoor; M Jewett; C Kollmannsberger; L Wood; G Bjarnason; D Heng; D Soulières; N Reaume; N Basappa; E Lévesque; A Dragomir Journal: Curr Oncol Date: 2018-12-01 Impact factor: 3.677
Authors: Sabrina Rossetti; Carmine D'Aniello; Gelsomina Iovane; Sarah Scagliarini; Maria M Laterza; Fernando De Vita; Clementina Savastano; Giacomo Cartenì; Maria A Porricelli; Massimiliano Berretta; Salvatore Pisconti; Gaetano Facchini; Carla Cavaliere Journal: Front Pharmacol Date: 2017-07-20 Impact factor: 5.810