Age and gender do not impact overall survival (OS) among patients who receive targeted therapy for metastatic renal cell carcinoma (mRCC), according to a new study.
Younger patients, however, have shorter progression-free survival (PFS), and elderly patients experience more adverse events, investigators reported in a paper published online in Clinical Genitourinary Cancer.
“These findings are important to guide clinicians when counseling patients about expectations and toxicity associated with therapy,” a team led by Rana R. McKay, MD, of the University of California San Diego, concluded.
Dr McKay and her collaborators conducted a pooled analysis of 4736 patients with mRCC who received targeted therapies in phase 2 and 3 clinical trials. They stratified patients by age: less than 50 years (young), 50 to 70 years (intermediate), and more than 70 years (elderly). Systemic treatments were sunitinib (22.4% of patients), axitinib (18.9%), temsirolimus-containing regimens (22.4%), bevacizumab-containing regimens (16.6%), sorafenib (16.3%), and interferon-alpha (11.8%).
Median overall survival (OS) times for the young, intermediate, and elderly groups were 20.0, 17.3, and 21.0 months, respectively. Median OS times for male and female patients were 19.8 and 19.0 months, respectively. The differences in OS times among the age and gender groups were not statistically significant.
The young group had a significantly shorter PFS than the intermediate group (6.0 vs 7.1 months), but was similar by gender.
“Although older age was not associated with inferior survival in our dataset, elderly patients experienced more frequent adverse events, including fatigue, diarrhea, decreased appetite, and decreased weight with treatment highlighting the need for vigilant adverse event prevention and management,” the authors noted. “However, the frequency of severe toxicity was similar among all groups.”
Panian J, Lin X, Simantov R, et al. The impact of age and gender on outcomes of patients with advanced renal cell carcinoma treated with targeted therapy. Clin Genitourin Cancer. doi: 10.1016/j.clgc.2020.03.010