Affiliation:
1. Keio University School of Medicine
Abstract
Abstract
Background
Due to an increase in life expectancy, the incidence of metastatic renal cell carcinoma (mRCC) in patients aged ≥75 years has been increasing. In this study we investigated the characteristics before treatment and the outcomes of systemic therapies for patients aged ≥75 years with mRCC and compared the results with those for patients aged <75years in order to determine whether differences in age influenced survival.
Methods
A total of 206 consecutive Japanese patients with mRCC, including 47 patients aged ≥75 years, who received systemic therapy were included. Clinical data from medical records were retrieved and analyzed retrospectively. Survival analyses were determined using a Kaplan–Meier method, and analyzed with a log-rank test.
Results
Elderly patients categorized as favorable risk group based on the International Metastatic RCC Database Consortium (IMDC) stratification system were significantly lower. Among IMDC risk factors, the rate of anemia was significantly higher in elderly patients. No statistically significant benefit in progression free survival for first and second line treatment was observed, whereas improvements in overall survival as well as cancer specific survival were seen in patients aged <75 years.
Conclusions
For mRCC patients aged ≥75 years, a higher proportion of base line anemia, which resulted in higher rates of IMDC intermediate/poor risk, would be responsible for shorter OS/CSS. Furthermore, mRCC patients aged ≥75 years tend to receive BSC instead of second line active treatment. Overcoming under-treatment in elderly patients might help to prolong survival in mRCC.
Publisher
Research Square Platform LLC
Reference17 articles.
1. Systemic Therapy for Metastatic Renal-Cell Carcinoma;Choueiri TK;N Engl J Med
2. Nivolumab plus Ipilimumab versus Sunitinib in Advanced Renal-Cell Carcinoma;Motzer RJ;N Engl J Med
3. Rini BI, Plimack ER, Stus V, Gafanov R, Hawkins R, Nosov D et al. Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma. N Engl J Med. 2019 Mar 21;380(12):1116-27.
4. Nivolumab plus Cabozantinib versus Sunitinib for Advanced Renal-Cell Carcinoma;Choueiri TK;N Engl J Med
5. Motzer R, Alekseev B, Rha SY, Porta C, Eto M, Powles T et al. Lenvatinib plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma. N Engl J Med. 2021 Apr 8;384(14):1289 – 300.