GRACE :: Kidney Cancer

Older adults and sunitinib: A formal evaluation

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With many cancer therapies, we always wonder about the potential impact and relevance in an elderly population. Dr. Hutson and colleagues recently published a report in the British Journal of Cancer in January of 2014 formally assessing this in the context of patients with metastatic renal cell carcinoma. In their study, they pooled data from 1059 patients that were treated across six clinical trials that utilized the agent sunitinib. Ultimately, what Dr. Hutson and his colleagues demonstrated is that the delay in tumor growth, known as progression free survival, seemed to be pretty comparable between younger and older patients. Specifically amongst younger patients median progression free survival was 9.9 months versus 11 months in older patients.  In addition to this, there were no significant differences in terms of median overall survival when patients received first line therapy with sunitinib. Notably, there were several toxicities that seemed to be more common in older adults as compared to younger adults. These toxicities included fatigue, cough, edema or swelling, as well as anemia, a low blood count, decreased appetite, and low platelet counts. Interestingly, the study found that hand-foot syndrome was more common in younger patients. These study results really seem to indicate that we shouldn’t be ageist in prescribing drugs for renal cell carcinoma, such as sunitinib. I would suggest that similar studies are warranted across other targeted agents that are currently in use for the disease.


2 Responses to Older adults and sunitinib: A formal evaluation

  • Sadly, these results only apply to the minority of elderly patients who met the strict eligibilty requirements to enter these six clinical trials. One could argue that this study does not have good external validity, because most elderly patients have many more comorbid conditions and social concerns that are not reflected in the study population.

  • Dr. Pal says:

    Hi Dr. Creelan, your points are well taken! Unfortunately, it may represent some of the better data we have at our disposal — the data was prospectively collected in a rigorous fashion in association with these trials. These results may therefore supersede some of the retrospective institutional and population-based studies that I have done on the topic. Thanks for your comment!

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