Friday, December 20, 2013

MRCC elderly patients should not be excluded from the targeted therapy option

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MRCC elderly patients should not be excluded from the targeted therapy option -

By Sarah Pritchard, medwireNews Reporter

Advanced age is not a due to prevent patients from receiving vascular endothelial growth factor (VEGF) -targeted therapy for metastatic renal cell carcinoma (mRCC), the results show the study of a population of mixed age patients.

Not only the median duration of treatment, overall response rates and comparable overall survival among those aged 75 years and above compared to their younger counterparts, but after adjusting the data for poor prognostic factors, older had no association with poor survival.

The study cohort included 1381 MRCC patients, of which 144 were aged 75 years or more. The most common initial treatment given to these seniors was sunitinib followed by sorafenib, bevacizumab and AZD2171 (cediranib). There was no significant difference in the distribution of risk groups - defined using the Heng Journal of Clinical Oncology 09 prognostic factors -. By age

Indeed, the main differences between basic people aged 75 and older and younger patients were less nephrectomies and brain metastases in the elderly population, notes Daniel Heng, the University of Calgary in Alberta, Canada, and the team.

The median duration of treatment was similar regardless of age, 5.5 and 7.5 months for the older and younger groups, respectively. Similarly, the overall response and median survival was also similar, with a respective 18% against 25%, and 16.8 months versus19.7

Data Heng and colleagues adjusted for factors poor prognosis known :. Levels below the lower limit of hemoglobin normal, Karnofsky performance status of less than 80%, a corrected serum calcium level higher than the upper limit of normal, increased serum neutrophils and platelets, and less than one year from the time of diagnosis and treatment of RCC.

the results of the multivariate analysis showed no association between the age of 75 years and the duration of treatment or overall survival ,, reported the research team.

These results are in contrast to the idea that elderly patients with RCC also present with comorbid conditions such as hypertension, diabetes, cardiovascular and cerebrovascular disease and other respiratory diseases, the researchers write in genitourinary Cancer clinic .

"because of these comorbidities related to age, it is believed that treatment may not be well tolerated," they added, suggesting that the use of targeted therapy in elderly patients RCC warrants further study.

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