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Angiogenesis inhibitor therapies for advanced renal cell carcinoma: toxicity and treatment patterns in clinical practice from a global medical chart review

Authors
 William K. Oh  ;  David Mcdermott  ;  Camillo Porta  ;  Antonin Levy  ;  Reza Elaidi  ;  Florian Scotte  ;  Robert Hawkins  ;  Daniel Castellano  ;  Joaquim Bellmunt  ;  Sun Young Rha  ;  Ray Mcdermott  ;  Paul Donnellan  ;  Cheng Keng Chuang  ;  Jose R. Diaz  ;  Jong Mu Sun  ;  Jin Hee Ahn  ;  Chao Yuan Huang  ;  Caroline Korves  ;  Faisal Mehmud  ;  Paul Nathan  ;  John Wagstaff  ;  John Mccaffrey  ;  Maureen P. Neary  ;  Mei Sheng Duh  ;  Bruce A. Feinberg  ;  Yen Hwa Chang  ;  Po Hui Chiang  ;  Jeffrey Scott  ;  Yen Chuan Ou 
Citation
 INTERNATIONAL JOURNAL OF ONCOLOGY, Vol.44(1) : 5-16, 2014 
Journal Title
INTERNATIONAL JOURNAL OF ONCOLOGY
ISSN
 1019-6439 
Issue Date
2014
MeSH
Adult ; Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/administration & dosage ; Angiogenesis Inhibitors/adverse effects ; Antibodies, Monoclonal, Humanized/administration & dosage* ; Antibodies, Monoclonal, Humanized/adverse effects ; Asia ; Bevacizumab ; Carcinoma, Renal Cell/drug therapy* ; Carcinoma, Renal Cell/epidemiology ; Carcinoma, Renal Cell/pathology ; Drug-Related Side Effects and Adverse Reactions/pathology ; Europe ; Female ; Humans ; Indoles/administration & dosage* ; Indoles/adverse effects ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Niacinamide/administration & dosage ; Niacinamide/adverse effects ; Niacinamide/analogs & derivatives* ; Phenylurea Compounds/administration & dosage* ; Phenylurea Compounds/adverse effects ; Pyrroles/administration & dosage* ; Pyrroles/adverse effects ; Treatment Outcome ; United States
Keywords
renal cell carcinoma ; angiogenesis inhibitors ; safety ; treatment patterns ; interruption ; dose reduction
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.
Files in This Item:
T201404194.pdf Download
DOI
10.3892/ijo.2013.2181
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138256
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