Are Age and Sex Linked to Mortality After Adjuvant Therapy for Kidney Cancer?
Among older women with renal cell carcinoma, adjuvant sunitinib after nephrectomy may be associated with increased mortality, based on the findings of a subgroup analysis of the ASSURE (E2805) trial. These findings were presented by Ronac Mamtani, MD, of the University of Pennsylvania, at the 2018 Genitourinary Cancers Symposium in San Francisco (Abstract 575). If these results are validated, they believe consideration of the impact of sex and age on treatment outcomes, future study designs, and tumor biology may be warranted.
This phase III trial included 1,943 patients with ≥ pT1b resected renal cell carcinoma. No apparent benefit in terms of overall and disease-free survival with adjuvant sunitinib or sorafenib relative to placebo was reported.
The subgroup analysis found increased mortality among women older than age 56 who were treated with sunitinib, compared with women younger than age 56 and men at any age also treated with sunitinib. They also noted that among these older women, the risk of disease recurrence was increased with sunitinib relative to placebo.
Dr. Mamtani and colleagues suggest that the increased mortality among these older women treated with adjuvant sunitinib after surgery “may be explained by an increased risk of renal cell carcinoma recurrence.”