89P Survival and immunotoxicity profiles in younger versus elderly patients with metastatic renal cell cancer undergoing immunotherapy

e15615 Background: Lymphopenia is associated with toxicity and outcome in several cancer types. We assessed the association of pre-treatment lymphopenia with toxicity and clinical outcome of elderly patients with metastatic renal cell cancer treated with first-line sunitinib. We evaluated the prognostic factors in these patients. Methods: We reviewed the clinical files of 181 patients aged >70 years with mRCC treated with first-line sunitinib in seventeen Italian Oncology Units from February 2006 to September 2011. Baseline lymphopenia was defined as lymphocyte counts <1,000/µL. Results: Twenty–nine patients (16.0%) had a baseline lymphocyte counts <1,000/µL, and 152 (84%) ≥1,000/µL. No difference between the two groups was reported in overall response rate (p = 0.207), dose reductions (p = 0.740); discontinuations due to adverse events (p = 0.175), overall incidence of grade 3-4 toxicities (p = 0.112) even if more patients in the group with lymphopenia had grade 3-4 neutropenia (p = 0.017), grade 3-4 thrombocytopenia (p = 0.017) and grade 3-4 diarrhea (p = 0.006). In multivariate analysis, performance status and Heng score were predictors of progression-free survival (p = 0.015 and p = 0.0006, respectively), while performance status, Heng score, and lymphopenia were found to be significantly associated with overall survival (p = 0.007, p < 0.0001 and p = 0.023, respectively). Conclusions: Sunitinib appeared safe and active in elderly patients with lymphopenia. Lymphocyte counts is an independent prognostic factor for OS in elderly patients with mRCC treated with first-line sunitinib.

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Standard vs Adapted Sunitinib Regimen in Elderly Patients With Metastatic Renal Cell Cancer: Results From a Large Retrospective Analysis

Clinical Genitourinary Cancer ◽

10.1016/j.clgc.2013.11.005 ◽

2014 ◽

Vol 12 (3) ◽

pp. 182-189 ◽

Cited By ~ 20

Author(s):

Ugo De Giorgi ◽

Emanuela Scarpi ◽

Cosimo Sacco ◽

Michele Aieta ◽

Giovanni Lo Re ◽

...

Keyword(s):

Elderly Patients ◽

Retrospective Analysis ◽

Renal Cell Cancer ◽

Renal Cell ◽

Cell Cancer ◽

Metastatic Renal Cell Cancer

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Lymphopenia and clinical outcome of elderly patients treated with sunitinib for metastatic renal cell cancer

Journal of Geriatric Oncology ◽

10.1016/j.jgo.2014.01.001 ◽

2014 ◽

Vol 5 (2) ◽

pp. 156-163 ◽

Cited By ~ 20

Author(s):

Ugo De Giorgi ◽

Karim Rihawi ◽

Michele Aieta ◽

Giovanni Lo Re ◽

Teodoro Sava ◽

...

Keyword(s):

Clinical Outcome ◽

Elderly Patients ◽

Renal Cell Cancer ◽

Renal Cell ◽

Cell Cancer ◽

Metastatic Renal Cell Cancer

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Toxicities of axitinib, sunitinib and temsirolimus: implications for progression-free and overall survival in metastatic renal cell cancer

Future Oncology ◽

10.2217/fon-2020-0900 ◽

2020 ◽

Author(s):

Annemarie Uhlig ◽

Johannes Uhlig ◽

Lutz Trojan ◽

Michael Woike ◽

Marianne Leitsmann ◽

...

Keyword(s):

Overall Survival ◽

Cancer Patients ◽

Skin Reaction ◽

Renal Cell Cancer ◽

Renal Cell ◽

Cell Cancer ◽

Progression Free Survival ◽

Cox Models ◽

Metastatic Renal Cell Cancer ◽

Hand Foot Skin Reaction

The aim of this study was to evaluate the association between axitinib, sunitinib and temsirolimus toxicities and patient survival in metastatic renal cell cancer patients. Overall survival (OS) and progression-free survival (PFS) of metastatic renal cell cancer patients from the prospective multicenter STAR-TOR study were assessed using multivariable Cox models. A total of 1195 patients were included (n = 149 axitinib; n = 546 sunitinib; n = 500 temsirolimus). The following toxicities significantly predicted outcomes: hand–foot skin reaction (hazard ratio [HR] = 0.29) for PFS with axitinib; stomatitis (HR = 0.62) and pneumonitis (HR = 0.23) for PFS with temsirolimus; stomatitis (HR = 0.52) and thrombocytopenia (HR = 0.6) for OS with temsirolimus; fatigue (HR = 0.71) for PFS with sunitinib; hand–foot skin reaction (HR = 0.56) and fatigue (HR = 0.58) for OS with sunitinib. In conclusion, in metastatic renal cell cancer, axitinib, sunitinib and temsirolimus demonstrate specific toxicities that are protective OS/PFS predictors.

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An Italian, multicenter, real-world, retrospective study of first-line pazopanib in unselected metastatic renal-cell carcinoma patients: the ‘Pamerit’ study

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa193 ◽

2020 ◽

Author(s):

Alessandra Mosca ◽

Ugo De Giorgi ◽

Giuseppe Procopio ◽

Umberto Basso ◽

Giacomo Cartenì ◽

...

Keyword(s):

Cancer Patients ◽

Renal Cell Cancer ◽

Real World ◽

Renal Cell ◽

Cell Cancer ◽

Progression Free Survival ◽

First Line ◽

Free Survival ◽

Metastatic Renal Cell Cancer ◽

Metastatic Rcc

Abstract Objective Despite the current immunotherapy era, VEGFR inhibitors maintain effectiveness in metastatic renal cell cancer. Real-world data concerning pazopanib are limited. The aim of this study is to add information about efficacy and safety of pazopanib as first-line treatment in metastatic renal cell cancer patients not enrolled into clinical trials. Methods Retrospective analysis (the PAMERIT study) of first-line pazopanib in real-world metastatic renal cell cancer patients among 39 Centers in Italy. Outcomes were progression-free survival, overall survival, objective response rate and treatment-related adverse events. Kaplan–Meier curves, log-rank test and multivariable Cox’s models were used and adjusted for age, histology, previous renal surgery, International Metastatic RCC Database Consortium score and pazopanib initial dose. Results Among 474 patients, 87.3% had clear cell metastatic renal cell cancer histology. Most of them (84.6%) had upfront renal surgery. Median progression-free survival and overall survival were 15.8 and 34.4 months, respectively, significantly correlating with International Metastatic RCC Database Consortium’s good prognosis (P < 0.001), ECOG PS 0 (P < 0.001), age (<75 years, P = 0.005), surgery (P < 0.001) and response to pazopanib (P < 0.001). After 3 months of pazopanib, overall disease control rate have been observed in 76.6% patients. Among International Metastatic RCC Database Consortium’s favorable group patients, 57/121 (47%) showed complete/partial response. No unexpected AEs emerged. Conclusions In this real-world study, metastatic renal cell cancer patients treated with first-line pazopanib reached greater progression-free survival and overall survival than in pivotal studies and had high response rates when belonging to International Metastatic RCC Database Consortium’s favorable group, without new toxicities. Pazopanib has been confirmed a valid first-line option for International Metastatic RCC Database Consortium’s good prognosis metastatic renal cell cancer patients who cannot be submitted to immunotherapy.

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