Angiogenesis inhibitor therapies for advanced renal cell carcinoma: toxicity and treatment patterns in clinical practice from a global medical chart review
Journal
International journal of oncology
Journal Volume
44
Journal Issue
1
Date Issued
2014-01
Author(s)
Oh, William K
McDermott, David
Porta, Camillo
Levy, Antonin
Elaidi, Reza
Scotte, Florian
Hawkins, Robert
Castellano, Daniel
Bellmunt, Joaquim
Rha, Sun Young
Sun, Jong-Mu
Nathan, Paul
Feinberg, Bruce A
Scott, Jeffrey
McDermott, Ray
Ahn, Jin-Hee
Wagstaff, John
Chang, Yen-Hwa
Ou, Yen-Chuan
Donnellan, Paul
McCaffrey, John
Chiang, Po-Hui
Chuang, Cheng-Keng
Korves, Caroline
Neary, Maureen P
Diaz, Jose R
Mehmud, Faisal
Duh, Mei Sheng
Abstract
The aim of this study was to assess the treatment patterns and safety of sunitinib, sorafenib and bevacizumab in real-world clinical settings in US, Europe and Asia. Medical records were abstracted at 18 community oncology clinics in the US and at 21 tertiary oncology centers in US, Europe and Asia for 883 patients ≥ 18 years who had histologically/cytologically confirmed diagnosis of advanced RCC and received sunitinib (n=631), sorafenib (n=207) or bevacizumab (n=45) as first-line treatment. No prior treatment was permitted. Data were collected on all adverse events (AEs) and treatment modifications, including discontinuation, interruption and dose reduction. Treatment duration was estimated using Kaplan-Meier analysis. Demographics were similar across treatment groups and regions. Median treatment duration ranged from 6.1 to 10.7 months, 5.1 to 8.5 months and 7.5 to 9.8 months for sunitinib, sorafenib and bevacizumab patients, respectively. Grade 3/4 AEs were experienced by 26.0, 28.0 and 15.6% of sunitinib, sorafenib and bevacizumab patients, respectively. Treatment discontinuations occurred in 62.4 (Asia) to 63.1% (US) sunitinib, 68.8 (Asia) to 90.0% (Europe) sorafenib, and 66.7 (Asia) to 81.8% (US) bevacizumab patients. Globally, treatment modifications due to AEs occurred in 55.1, 54.2 and 50.0% sunitinib, sorafenib and bevacizumab patients, respectively. This study in a large, global cohort of advanced RCC patients found that angiogenesis inhibitors are associated with high rates of AEs and treatment modifications. Findings suggest an unmet need for more tolerable agents for RCC treatment.
Subjects
Angiogenesis inhibitors | Dose reduction | Interruption | Renal cell carcinoma | Safety | Treatment patterns
Angiogenesis inhibitors; Dose reduction; Interruption; Renal cell carcinoma; Safety; Treatment patterns
SDGs
Other Subjects
bevacizumab; interferon; sorafenib; sunitinib; abdominal pain; adult; advanced cancer; aged; alopecia; anemia; anorexia; article; Asia; asthenia; bleeding; cancer chemotherapy; chill; clinical practice; cohort analysis; constipation; coughing; dehydration; diarrhea; drug safety; drug withdrawal; dyspnea; edema; epistaxis; Europe; fatigue; female; fever; follow up; hand foot syndrome; histopathology; human; hypertension; hypothyroidism; kidney carcinoma; major clinical study; male; medical record review; middle aged; mouth pain; mucosa inflammation; multicenter study; nausea; pain; priority journal; proteinuria; rash; stomatitis; taste disorder; thrombocytopenia; treatment duration; United States; unspecified side effect; urogenital tract disease; very elderly; vomiting; weight reduction; young adult; Adult; Aged; Aged, 80 and over; Angiogenesis Inhibitors; Antibodies, Monoclonal, Humanized; Asia; Carcinoma, Renal Cell; Drug-Related Side Effects and Adverse Reactions; Europe; Female; Humans; Indoles; Kaplan-Meier Estimate; Male; Middle Aged; Niacinamide; Phenylurea Compounds; Pyrroles; Treatment Outcome; United States
Type
journal article