Age-Based Outcomes in Metastatic Renal Cell Carcinoma
Posted: Tuesday, February 23, 2021
Age did not appear to affect overall survival or progression-free survival in patients with metastatic renal cell carcinoma treated with first-line targeted therapy or checkpoint immunotherapy. Still, toxicity was more likely in older patients, according to a recent retrospective study. Frede Donskov, MD, DMSc, and Carina K. Hermansen, MD, of Aarhus University Hospital in Denmark, published their results in the Journal of Geriatric Oncology.
“Proactive dose modification/interruption and awareness may help to reduce toxicity while maintaining efficacy,” the authors wrote. “To ensure clinical benefit of targeted drugs, the sustained drug exposure in each individual patient, rather than the numerical dose in mg per se, is important.”
The study analyzed 838 patients with metastatic renal cell carcinoma: 19% were 75 years or older, 39% were between 65 and 74, and 42% were younger than 65. Patients received treatment with first-line tyrosine kinase inhibitors (87% of patients), mTOR inhibitors (5%), or checkpoint immunotherapy (8%).
The authors found that age did not affect overall survival or progression-free survival when adjusting the hazard ratios for the International Metastatic Renal Cell Carcinoma Database Consortium risk factors and histology. However, toxicity and toxicity-related dose reduction or interruption were more likely in patients 75 years or older. These older patients also experienced a shorter time from the beginning of therapy to dose reduction or interruption.
Several previous studies also reported that age was not associated with poorer survival in patients with metastatic renal cell carcinoma. However, according to these authors, this is reportedly the most extensive real-world single-center study of age-based outcomes of these treatments in this patient population.
Disclosure: The study authors’ disclosures may be found at sciencedirect.com.