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Older age did not worsen targeted mRCC therapy outcomes
Targeted therapy conferred similar overall response rates and OS among older and younger patients with metastatic renal cell carcinoma, according to results of a retrospective study.
The analysis included 1,381 patients who received first-line anti-VEGF targeted therapy. Using Heng criteria published in the Journal of Clinical Oncology in 2009, researchers determined most patients had intermediate-risk disease (69%), whereas 4% had favorable-risk disease and 27% had poor-risk disease.
Ten percent (n=144) of patients were aged 75 years or older. Among these patients, 98 received sunitinib (Sutent, Pfizer) as initial treatment, whereas 35 received sorafenib (Nexavar, Bayer), seven received bevacizumab (Avastin, Genentech) and four received AZD2171 (Cediranib, AstraZeneca).
A higher percentage of younger patients went on to receive second-line therapy (39% vs. 23%; P˂.0001).
Researchers reported overall response rates of 25% among younger patients vs. 18% for older patients (P=.0975). Younger patients demonstrated longer median treatment duration (7.5 months vs. 5.5 months; P=.1388) and OS (19.7 months vs. 16.8 months; P=.3321), but these differences were not statistically significant.
When researchers adjusted analyses for poor prognostic factors, they found older age was not linked to poorer OS (HR=1.002; 95% CI, 0.781-1.285) or shorter treatment duration (HR=1.018; 95% CI, 0.827-1.252).
“Targeted therapy has become the mainstay of treatment for metastatic renal cell carcinoma, and the efficacy of this therapy in the older population is poorly understood,” the researchers wrote. “When adjusted for poor prognostic factors, age 75 years and above was not found to be associated with poorer OS or shorter treatment duration. This suggests that advanced age alone should not preclude a patient from targeted therapy.”
Disclosure: The researchers report honoraria and research funding from Bayer, Novartis and Pfizer.