PATIENT counselling is more important than ever for those with cancer, especially considering the burgeoning number of treatments available and the equally diverse range of potential adverse events associated with them. In order to help patients with metastatic renal cell carcinoma (mRCC) develop better expectations of their therapy, researchers from the University of California, San Diego, California, USA, have determined age and sex to not affect overall survival when receiving targeted therapies.
A pooled analysis of 4,736 patients with mRCC who had received targeted therapies in Phase I and II clinical trials was performed. The patients were stratified into three age-based criteria: less than 50 (young), 50–70 (intermediate), and more than 70 years of age (elderly). The patients had received a variety of systemic treatments, including sunitinib (22.4%), axitinib (18.9%), temsirolimus-containing regimens (22.4%), bevacizumab-containing regimens (16.6%), sorafenib (16.3%), and IFN-α (11.8%).
The study revealed that the elderly sub-group exhibited median overall survival similar to those of younger patients (young: 20.0 months; intermediate: 17.3 months; elderly: 21.0 months). The durations of median overall survival were also comparable across both male and female patients (19.8 and 19.0 months, respectively). In all instances, these differences were not statistically significant. Additionally, the young sub-group had a shorter progression-free survival than the intermediate sub-group (6.0 versus 7.1 months).
The authors noted that although older age was not associated with inferior survival in the dataset, elderly patients experienced more frequent adverse events, including fatigue, diarrhoea, decreased appetite, and decreased weight with treatment, highlighting the need for vigilant adverse event prevention and management. The frequency of severe toxicity however was similar among all groups.
As we witness patients be engaged and empowered in the lead-up to, throughout, and following their treatment regimen in the form of increased dialogue with the treating clinician, the dispelling of misconceptions regarding the detrimental influence of baseline characteristics is clearly important. Team leader Dr Rana R. McKay lamented that “these findings are important to guide clinicians when counselling patients about expectations and toxicity associated with therapy.”
