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P140

Outcome of octogenarian versus young patients with metastatic renal cell carcinoma, treated with sunitinib

By:

Neiman V.1, Kushnir I.2, Rosenbaum E.1, Sarid D.2, Sella A.3, Gottfried M.4, Maimon N.4, Peer A.5, Neumann A.5, Kovel S.3, Gez E.2, Mermershtain W.6, Rouvinov K.6, Carducci M.7, Eisenberger M.7, Hammers H.7, Sinibaldi V.7, Berger R.8, Keizman D.4

Institutes:

1Rabin Medical Center, Davidoff Cancer Center, Petach Tikva, Israel, 2Tel-Aviv Medical Center, Dept. of Oncology, Tel Aviv, Israel, 3Asaf Harofe Medical Center, Dept. of Oncology, Zerifin, Israel, 4Meir Medical Center, Dept. of Oncology, Kfar Saba, Israel, 5Rambam Medical Center, Dept. of Oncology, Haifa, Israel, 6Soroka Medical Center, Dept. of Oncology, Beersheba, Israel, 7Johns Hopkins, Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States of America, 8Sheba Medical Center, Dept. of Oncology, Tel Hashomer, Israel

Introduction & Objectives

Sunitinib (su) is a standard treatment (tx) for metastatic Renal Cell Carcinoma (mRCC). Octogenarian patients (pts) (aged ≥ 80) are often considered to be unfit for su tx, and recommendations for their tx is limited by the paucity of clinical trials data in this population. We aimed to study baseline characteristics and outcome of octogenarian versus (vs) young (aged ≤45) pts with mRCC treated with su.

Material & Methods

We performed an international multicenter retrospective study of pts with mRCC, who were treated with su in 8 centers across 2 different countries. We compared baseline characteristics and outcome of octogenarian versus young pts. The effect of very old age on Response Rate (RR), Progression Free Survival (PFS) and Overall Survival (OS), was tested with adjustment of other known confounding risk factors using a chi-square test and partial likelihood test from cox model. Furthermore, univariate and multivariate analyses of association between clinicopathologic factors and age, and outcome were performed using the entire pt cohort.

Results

Between 2004-2013, 36 octogenarian (group 1; median age 83) and 37 young (group 2; median age 42) mRCC were treated with su. The groups were balanced regarding the following baseline clinicopathologic characteristics: gender, HENG risk, past nephrectomy, mRCC histology, ≥ 2 metastatic sites, lung/liver/bone metastasis, prior targeted tx, smoking status, use of angiotensin system inhibitors (ASIs), pre-tx neutrophil to lymphocyte ratio (NLR) >3, and sunitinib induced hypertension (HTN). In group 1 vs 2, 53% vs 27% (p=0.006) had dose reduction/treatment interruption d/t side effects. Clinical benefit (partial response + stable disease) in group 1 vs 2 was 76% vs 84%, while 24% vs 16% had disease progression within the first 3 months of tx (p=0.09). Median PFS was 11 vs 8 months (p=0.1). Median OS was 22 vs 20 months (p=0.7). In multivariate analyses of the entire pt cohort (n=73), age was not significantly associated with PFS or OS.

Conclusions

Su is active in octogenarian mRCC pts. Vs young pts, a significantly higher proportion of octogenarian pts had dose reduction/treatment interruption d/t side effects.

  • Type: Abstract
  • Date: 26-11-2016
  • Rating: 0,0
  • Views: 116
  • Event: 8th European Multidisciplinary Meeting on Urological Cancers
  • Nr: P140
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