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Medline ® Abstract for Reference 15

of 'Anti-angiogenic and molecularly targeted therapy for advanced or metastatic clear-cell renal cell carcinoma'

Efficacy and safety of sunitinib in elderly patients with metastatic renal cell carcinoma.
Hutson TE, Bukowski RM, Rini BI, Gore ME, Larkin JM, Figlin RA, Barrios CH, Escudier B, Lin X, Fly K, Martell B, Matczak E, Motzer RJ
Br J Cancer. 2014 Mar;110(5):1125-32. Epub 2014 Jan 16.
Background:We retrospectively analyzed sunitinib outcome as a function of age in metastatic renal cell carcinoma (mRCC) patients.Methods:Data were pooled from 1059 patients in six trials. Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS) were compared by log-rank test between patients aged<70 (n=857; 81%) and70 (n=202; 19%) years.Results:In first-line patients, median PFS was comparable in younger and older patients, 9.9 vs 11.0 months, respectively (HR, 0.89; 95% CI: 0.73-1.09; P=0.2629), as was median OS, 23.6 vs 25.6 months (HR, 0.93; 95% CI: 0.74-1.18; P=0.5442). Similarly, in cytokine-refractory patients, median PFS was 8.1 vs 8.4 months (HR, 0.79; 95% CI: 0.49-1.28; P=0.3350), while median OS was 20.2 vs 15.8 months (HR, 1.14; 95% CI: 0.73-1.79; P=0.5657). Some treatment-emergent adverse events were significantly less common in younger vs older patients, including fatigue (60% vs 69%), cough (20% vs 29%), peripheral edema (17% vs 27%), anemia (18% vs 25%), decreased appetite (13% vs 29%), and thrombocytopenia (16% vs 25%; all P<0.05). Hand-foot syndrome was more common in younger patients (32% vs 24%).Conclusions:Advanced age should not be a deterrent to sunitinib therapy and elderly patients may achieve additional clinical benefit.
Baylor Sammons Cancer Center-Texas Oncology, PA, Dallas, TX, USA.