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Bhandari NR, Ounpraseuth ST, Kamel MH, Kent EE, McAdam-Marx C, Tilford JM, Payakachat N. Changes in health-related quality of life outcomes in older patients with kidney cancer: A longitudinal cohort analysis with matched controls. Urol Oncol 2020; 38:852.e11-852.e20. [PMID: 32863123 DOI: 10.1016/j.urolonc.2020.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/21/2020] [Accepted: 08/05/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Current evidence regarding health-related quality of life (HRQoL) changes among patients with kidney cancer (KC) is limited. We characterized HRQoL changes from before (baseline) to after (follow-up) diagnosis of KC in older Americans relative to matched controls, and identified sociodemographic and clinical factors associated with HRQoL changes in older patients with KC. MATERIALS AND METHODS This longitudinal, population-based, retrospective cohort study used data from Surveillance, Epidemiology and End Results linked with Medicare Health Outcomes Survey, 1998-2013. Participants aged ≥65 years with baseline and follow-up survey data were identified. Those with primary KC (n = 186) were matched to adults without cancer (n = 558). HRQoL (physical component summary and mental component summary [MCS]) changes in KC patients were compared using generalized linear mixed-effects models to those of controls. Regression models were used to identify baseline factors associated with HRQoL changes. RESULTS The adjusted least squares mean (95% confidence interval) reduction in physical component summary from baseline to follow-up was greater in KC patients vs. controls (-4.1 [-5.6, -2.7] vs. -2.3 [-3.1, -1.4], P = 0.025). While the reduction in MCS was similar in both groups (-2.4 [-3.9, -0.8] vs. -1.5 [-2.4, -0.6], P = 0.338). Lower income and distant stage KC predicted greater declines in MCS among KC patients. CONCLUSION KC significantly affects overall general health in older patients, with sociodemographic factors and distant KC predicting greater reductions in HRQoL. Findings may help clinicians set patient expectations about their HRQoL post-diagnosis and increase clinician awareness of risk factors for HRQoL deterioration.
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Affiliation(s)
- Naleen Raj Bhandari
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR
| | | | - Mohamed H Kamel
- Department of Urology, UAMS, Little Rock, AR; Department of Urology, Ain Shams University, Cairo, Egypt
| | - Erin E Kent
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carrie McAdam-Marx
- Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE
| | - J Mick Tilford
- Department of Health Policy and Management, UAMS, Little Rock, AR
| | - Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR.
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Graham J, Shah AY, Wells JC, McKay RR, Vaishampayan U, Hansen A, Donskov F, Bjarnason GA, Beuselinck B, De Velasco G, Iafolla M, Duh MS, Huynh L, Chang R, Zanotti G, Ramaswamy K, Choueiri TK, Tannir NM, Heng DYC. Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors. Eur Urol Oncol 2019; 4:102-111. [PMID: 31786162 DOI: 10.1016/j.euo.2019.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/20/2019] [Accepted: 11/09/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Immuno-oncology (IO) therapies have changed the treatment standards of metastatic renal cell carcinoma (mRCC). However, the effectiveness of targeted therapy following discontinuation of IO therapy in real-world settings has not been well studied. OBJECTIVE To describe treatment sequence and assess clinical effectiveness of targeted therapy for mRCC patients who received prior IO therapy. DESIGN, SETTING, AND PARTICIPANTS A retrospective, longitudinal cohort study using data from eight international cancer centers was conducted. Patients with mRCC were ≥18yr old, received IO therapy in any line, and initiated targeted therapy following IO therapy discontinuation. INTERVENTION Patients were treated with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) or mammalian target of rapamycin inhibitors (mTORIs). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Outcomes were time to treatment discontinuation (TTD), overall survival (OS), and objective response rate (ORR). Crude and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Models were adjusted for age, sex, therapy line, and International Metastatic RCC Database Consortium risk group. RESULTS AND LIMITATIONS Among 314 patients, 276 (87.9%) and 38 (12.1%) were treated with VEGFR-TKI and mTORI therapy, respectively. The most common tyrosine kinase inhibitor treatments were axitinib, cabozantinib, and sunitinib following IO therapy. In adjusted models, patients treated with VEGFR-TKI versus mTORI therapy had lower hazard of TTD after IO treatment (aHR=0.46; 95% CI: 0.30-0.71; p < 0.01). One-year OS probability (65% vs 47%, p < 0.01) and proportion of ORR (29.8% vs 3.6%, p < 0.01) were significantly greater for patients treated with VEGFR-TKIs versus those treated with mTORIs. CONCLUSIONS Targeted therapy has clinical activity following IO treatment. Patients who received VEGFR-TKIs versus mTORIs following IO therapy had improved clinical outcomes. These findings may help inform treatment guidelines and clinical practice for patients post-IO therapy. PATIENT SUMMARY Patients may continue to experience clinical benefits from targeted therapies after progression on immuno-oncology treatment.
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Affiliation(s)
- Jeffrey Graham
- CancerCare Manitoba, University of Manitoba, Winnipeg, Canada
| | | | | | - Rana R McKay
- University of California San Diego, San Diego, CA, USA
| | | | - Aaron Hansen
- Princess Margaret Cancer Centre, Toronto, Canada
| | | | | | | | | | | | - Mei S Duh
- Analysis Group, Inc., Boston, MA, USA
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Cella D, Motzer RJ, Rini BI, Cappelleri JC, Ramaswamy K, Hariharan S, Arondekar B, Bushmakin AG. Important Group Differences on the Functional Assessment of Cancer Therapy-Kidney Symptom Index Disease-Related Symptoms in Patients with Metastatic Renal Cell Carcinoma. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:1413-1418. [PMID: 30502785 PMCID: PMC6788639 DOI: 10.1016/j.jval.2018.04.1371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 03/26/2018] [Accepted: 04/02/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The Functional Assessment of Cancer Therapy-Kidney Symptom Index Disease-Related Symptoms (FKSI-DRS) is important to gauge clinical benefit in metastatic renal cell carcinoma (mRCC). OBJECTIVES To estimate important difference (ID) in FKSI-DRS scores that is considered to be meaningful when comparing treatment effect between groups, using mRCC trial data. METHODS Data were derived from two pivotal phase III mRCC trials comparing sunitinib versus interferon alfa (N = 750) in first-line mRCC, and axitinib versus sorafenib (N = 723) in second-line mRCC. The change from baseline in FKSI-DRS score was examined as a function of a set of anchors using the repeated-measures model. Several anchors were evaluated: FKSI item "I am bothered by side effects of treatment," EuroQol five-dimensional questionnaire utility score, and adverse events. RESULTS When the "I am bothered by side effects of treatment" score was used as an anchor, the ID ranged between 1.2 and 1.3 points. When change in the EuroQol five-dimensional questionnaire utility score was used as an anchor, the FKSI-DRS ID ranged between 0.62 and 0.63 points. Selecting the adverse events that corresponded to a maximum worsening in the FKSI-DRS score in either trial, the ID ranged between 0.62 and 0.74 points. CONCLUSIONS Among patients undergoing treatment for mRCC, between-group differences in FKSI-DRS scores as low as 1 point might be meaningful.
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Affiliation(s)
- David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA.
| | | | - Brian I Rini
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
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de Groot S, Redekop WK, Versteegh MM, Sleijfer S, Oosterwijk E, Kiemeney LALM, Uyl-de Groot CA. Health-related quality of life and its determinants in patients with metastatic renal cell carcinoma. Qual Life Res 2017; 27:115-124. [PMID: 28917029 PMCID: PMC5770482 DOI: 10.1007/s11136-017-1704-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Based on improvements of progression-free survival (PFS), new agents for metastatic renal cell carcinoma (mRCC) have been approved. It is assumed that one of the benefits is a delay in health-related quality of life (HRQoL) deterioration as a result of a delay in progression of disease. However, little data are available supporting this relationship. This study aims to provide insight into the most important determinants of HRQoL (including progression of disease) of patients with mRCC. METHODS A patient registry (PERCEPTION) was created to evaluate treatment of patients with (m)RCC in the Netherlands. HRQoL was measured, using the EORTC QLQ-C30 and EQ-5D-5L, every 3 months in the first year of participation in the study, and every 6 months in the second year. Participation started as soon as possible following a diagnosis of (m)RCC. Random effects models were used to study associations between HRQoL and patient and disease characteristics, symptoms and treatment. RESULTS Eighty-seven patients with mRCC completed 304 questionnaires. The average EORTC QLQ-C30 global health status was 69 (SD, 19) before progression and 61 (SD, 22) after progression of disease. Similarly, the average EQ-5D utility was 0.75 (SD, 0.19) before progression and 0.66 (SD, 0.30) after progression of disease. The presence of fatigue, pain, dyspnoea, and the application of radiotherapy were associated with significantly lower EQ-5D utilities. CONCLUSIONS Key drivers for reduced HRQoL in mRCC are disease symptoms. Since symptoms increase with progression of disease, targeted therapies that increase PFS are expected to postpone reductions in HRQoL in mRCC.
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Affiliation(s)
- S de Groot
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P. O. Box 1738, 3000 DR, Rotterdam, The Netherlands. .,Institute for Medical Technology Assessment, Erasmus University Rotterdam, P. O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
| | - W K Redekop
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P. O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - M M Versteegh
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P. O. Box 1738, 3000 DR, Rotterdam, The Netherlands.,Institute for Medical Technology Assessment, Erasmus University Rotterdam, P. O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - S Sleijfer
- Department of Medical Oncology and Cancer Genomics Netherlands, Erasmus MC Cancer Institute, P. O. Box 5201, 3008 AE, Rotterdam, The Netherlands
| | - E Oosterwijk
- Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - L A L M Kiemeney
- Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - C A Uyl-de Groot
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P. O. Box 1738, 3000 DR, Rotterdam, The Netherlands.,Institute for Medical Technology Assessment, Erasmus University Rotterdam, P. O. Box 1738, 3000 DR, Rotterdam, The Netherlands
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Gupta AA, Chi YY, Anderson JR, Lyden E, Weigel B, Arndt C, Meyer WH, Rosenberg A, Hawkins DS. Patterns of chemotherapy-induced toxicities and outcome in children and adolescents with metastatic rhabdomyosarcoma: A report from the Children's Oncology Group. Pediatr Blood Cancer 2017; 64:10.1002/pbc.26479. [PMID: 28333415 PMCID: PMC5567865 DOI: 10.1002/pbc.26479] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/18/2016] [Accepted: 01/11/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND We sought to determine whether adolescents with metastatic alveolar rhabdomyosarcoma (ARMS) or embryonal RMS (ERMS) had a different event-free survival (EFS) compared with younger patients, and to identify treatment-related factors (adverse events, AEs) that may be associated with differences in outcome. METHODS The prevalence of AEs in adolescents older than 13 years was compared with that in patients less than or equal to 13 years of age (Fisher exact test) in patients enrolled onto ARST0431. EFS by age and histology was compared by log-rank test. RESULTS Of 109 patients, 60 (55%) were older than 13 years; they were more likely to have nausea (17 vs. 4%, P = 0.06) and pain (20 vs. 6%, P = 0.05) compared with younger patients. Adolescents were less likely to complete therapy (63 vs. 76%) and more likely to have unplanned dose modifications outside of protocol guidelines (23 vs. 2.7%). The 3-year EFS was 26% (95% confidence interval [CI]: 15-38) for adolescents compared with 46% (95% CI: 32-60) for those less than or equal to 13 years (P = 0.011). Forty-two (59%) adolescents with ARMS had a 3-year EFS of 13% (95% CI: 2-23) compared with 30% (95% CI: 10-51) for those less than or equal to 13 years (P = 0.032). EFS was comparable between older and younger patients with ERMS (64 vs. 55%, P = 0.53). CONCLUSIONS Although there was a significant difference in EFS and protocol compliance by age, the differences in age-related toxicity are unlikely to account for this. Observed differences in pain and nausea by age could be real or be dependent on patient reporting of symptoms. Future studies in RMS should include patient-reported outcomes to better evaluate health-related quality of life.
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Affiliation(s)
- Abha A. Gupta
- Department of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Yueh-Yun Chi
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - James R. Anderson
- Frontier Science and Technology Research Foundation, Madison, Wisconsin
| | - Elizabeth Lyden
- Preventive and Societal Medicine, Nebraska Medical Center, Omaha, Nebraska
| | - Brenda Weigel
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Minnesota Medical Center, Minneapolis, Minnesota
| | | | - William H. Meyer
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Abby Rosenberg
- Division of Hematology/Oncology, Department of Pediatrics, Seattle Children’s Hospital, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Douglas S. Hawkins
- Division of Hematology/Oncology, Department of Pediatrics, Seattle Children’s Hospital, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, Washington
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Creel PA. Optimizing patient adherence to targeted therapies in renal cell carcinoma. Clin J Oncol Nurs 2016; 18:694-700. [PMID: 25427704 DOI: 10.1188/14.cjon.694-700] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current standard of care for treating metastatic renal cell carcinoma is sequential therapy with vascular endothelial growth factor-targeted agents (i.e., axitinib, bevacizumab, pazopanib, sorafenib, and sunitinib) and mammalian target of rapamycin inhibitors (i.e., everolimus and temsirolimus). To maximize adherence to and persistence with targeted therapy, which should help improve clinical benefit, a clear understanding of the tolerability profiles of these agents and implementation of early, appropriately aggressive adverse event (AE) prevention and management strategies are key. Active and aggressive AE management should improve the quality of life of patients during the course of their treatment. Nurses are in a unique position to educate patients on the potential AEs they may experience and their prevention and management. This article reviews the safety and tolerability of currently available targeted therapies recommended for use in the second-line treatment setting, as well as their management in the context of maximizing clinical outcomes and patient quality of life.
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Cella D, Grünwald V, Nathan P, Doan J, Dastani H, Taylor F, Bennett B, DeRosa M, Berry S, Broglio K, Berghorn E, Motzer RJ. Quality of life in patients with advanced renal cell carcinoma given nivolumab versus everolimus in CheckMate 025: a randomised, open-label, phase 3 trial. Lancet Oncol 2016; 17:994-1003. [PMID: 27283863 DOI: 10.1016/s1470-2045(16)30125-5] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 04/29/2016] [Accepted: 04/29/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND In the phase 3 CheckMate 025 study, previously treated patients with advanced renal cell carcinoma who were randomly assigned to nivolumab had an overall survival benefit compared with those assigned to everolimus. We aimed to compare health-related quality of life (HRQoL) between treatment groups in this trial. METHODS CheckMate 025 was an open-label study done at 146 oncology centres in 24 countries. Patients were randomly assigned to treatment between Oct 22, 2012, and March 11, 2014. Patients with advanced renal cell carcinoma were randomly assigned (1:1, block size of four) to receive nivolumab every 2 weeks or everolimus once per day. The study was stopped early at the planned interim analysis in July, 2015, because the study met its primary endpoint. A protocol amendment permitted patients in the everolimus group to cross over to nivolumab treatment. All patients not on active study therapy are being followed up for survival. At the interim analysis, HRQoL was assessed with the Functional Assessment of Cancer Therapy-Kidney Symptom Index-Disease Related Symptoms (FKSI-DRS) and European Quality of Life (EuroQol)-5 Dimensions (EQ-5D) questionnaires. Prespecified endpoints were to assess, in each treatment group, disease-related symptom progression rate based on the FKSI-DRS and changes in reported global health outcomes based on the EQ-5D. Other endpoints were post hoc. We calculated the proportion of FKSI-DRS questionnaires completed using the number of patients with non-missing data at baseline and at least one post-baseline visit. We defined FKSI-DRS completion as completion of five or more of the nine items in the questionnaire; otherwise data were treated as missing. FKSI-DRS symptom index score was prorated for missing items. We made no adjustments for missing EQ-5D data. We used descriptive statistics and multivariate analyses, including mixed-effects model repeated-measures, for between group comparisons. Analyses were powered according to the original study protocol, and we analysed FKSI-DRS and EQ-5D data for all patients who underwent randomisation and had a baseline assessment and at least one post-baseline assessment. CheckMate 025 is registered with ClinicalTrials.gov, number NCT01668784. FINDINGS HRQoL data were collected at baseline for 362 (88%) of 410 patients in the nivolumab group and 344 (84%) of 411 patients in the everolimus group. The mean difference in FKSI-DRS scores between the nivolumab and everolimus groups was 1·6 (95% CI 1·4-1·9; p<0·0001) with descriptive statistics and 1·7 (1·2-2·1; p<0·0001) with mixed-effects model repeated-measures analysis. In terms of FKSI-DRS score, more patients had a clinically meaningful (ie, an increase of at least 2 points from baseline) HRQoL improvement with nivolumab (200 [55%] of 361 patients) versus everolimus (126 [37%] of 343 patients; p<0·0001). Median time to HRQoL improvement was shorter in patients given nivolumab (4·7 months, 95% CI 3·7-7·5) than in patients given everolimus (median not reached, NE-NE). INTERPRETATION Nivolumab was associated with HRQoL improvement compared with everolimus in previously treated patients with advanced renal cell carcinoma. FUNDING Bristol-Myers Squibb.
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García-Carbonero R, Vera R, Rivera F, Parlorio E, Pagés M, González-Flores E, Fernández-Martos C, Corral MÁ, Bouzas R, Matute F. SEOM/SERAM consensus statement on radiological diagnosis, response assessment and follow-up in colorectal cancer. Clin Transl Oncol 2016; 19:135-148. [DOI: 10.1007/s12094-016-1518-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/30/2016] [Indexed: 12/31/2022]
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Wagstaff J, Jones R, Hawkins R, Porfiri E, Pickering L, Bahl A, Brown J, Buchan S. Treatment patterns and clinical outcomes in patients with renal cell carcinoma in the UK: insights from the RECCORD registry. Ann Oncol 2015; 27:159-65. [PMID: 26489444 PMCID: PMC4684158 DOI: 10.1093/annonc/mdv504] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 10/11/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The aim of the RECCORD registry was to gather real-world UK data on the use of targeted therapies in renal cell carcinoma (RCC) and assess clinical outcomes. Here, demographic and outcome data are presented with the treatment patterns and demographic profile of patients on the registry. PATIENTS AND METHODS Patients were retrospectively identified at seven UK hospitals with large cancer centres in England (5), Scotland (1) and Wales (1). Anonymised data were collected through an online registry covering demographics, treatments and outcomes. Five hundred and fourteen UK adult patients with metastatic RCC were included in the study for analysis. Patients were included if they were treated for metastatic RCC at one of the seven centres, and started systemic anti-cancer treatment from March 2009 to November 2012 inclusive. In addition to demographic factors, the principal outcome measures were overall survival (OS), time to disease progression and toxicity. RESULTS The majority of first-line treatment was with sunitinib; first-line use of pazopanib increased as the study progressed. 15.8% of patients received second-line treatment, half of whom were prescribed everolimus. Median OS (from initiation of first-line treatment) was 23.9 months (95% confidence interval [CI] 18.6-29.1 months), similar to that reported for clinical trials of targeted RCC therapies [Ljungberg B, Campbell SC, Choi HY et al. The epidemiology of renal cell carcinoma. Eur Urol 2011; 60: 615-621; Abe H, Kamai T. Recent advances in the treatment of metastatic renal cell carcinoma. Int J Urol 2013; 20: 944-955; Motzer RJ, Hutson TE, Tomczak P et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol 2009; 27: 3584-3590]. OS was significantly longer for those who received second-line treatment after disease progression (33.0 months; 95% CI 30.8-35.2 months) than those who did not (20.9 months; 95% CI 16.4-25.3 months; P = 0.008). CONCLUSIONS RECCORD is a large 'real-world' database assessing metastatic RCC treatment patterns and outcomes. Treatment patterns changed over time as targeted therapies were approved and became widely available; survival data in RECCORD are consistent with those reported for systemic treatments in clinical trials. Kaplan-Meier analysis of results demonstrated that receiving second-line therapy was a major prognostic factor for longer OS.
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Affiliation(s)
- J Wagstaff
- South West Wales Cancer Institute and Swansea University College of Medicine, Swansea
| | - R Jones
- Beatson West of Scotland Cancer Centre, Glasgow
| | - R Hawkins
- The Christie Hospital NHS Trust, Manchester
| | - E Porfiri
- Department of Oncology, Queen Elizabeth Hospital, Birmingham
| | - L Pickering
- Department of Urology, Royal Marsden Hospital, London
| | - A Bahl
- Bristol Haematology and Oncology Centre, Bristol
| | - J Brown
- St James' University Hospital, Leeds
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