838P - Characteristics and prognostic factors in 455 elderly pts over 70 with metastatic renal cell carcinoma (mRCC) treated with target therapies (TT) in...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Renal Cell Cancer
Geriatric Oncology
Presenter Anna Paola Fraccon
Citation Annals of Oncology (2014) 25 (suppl_4): iv280-iv304. 10.1093/annonc/mdu337
Authors A.P. Fraccon1, F. Pasini2, U. Basso3, F. Larussa4, F. Valduga5, G. Lo Re6, C. Graiff7, G. Rosti8, A. Bearz9, D. Sartori10, C. Abeni11, F. Grillone12, G. Vicario13, C. Pegoraro14, F. Bassan15, D. Da Corte16, C. Modonesi17, R. Segati18, M. Medici19, C. Barile20
  • 1Medical Oncology, Casa di Cura Polispecialistica Dott. Pederzoli Presidio Ospedaliero ULSS 22, 37019 - Peschiera Del Garda/IT
  • 2Medical Oncology, Ospedale S. Maria della Misericordia Azienda Sanitaria Local 18 Rovigo, Rovigo/IT
  • 3Medical Oncology, IOV-IRCCS, 35138 - Padova/IT
  • 4Medical Oncology, dO AOUI, Verona/IT
  • 5Medical Oncology, St Chiara Hospital, 38122 - Trento/IT
  • 6Medical Oncology, Ospedale, Pordenone/IT
  • 7Medical Oncology, Ospedale Centrale di Bolzano ASDAA/SABES, Bolzano/IT
  • 8Oncology, Ospedale Regionale Ca' Foncello, 31100 - Treviso/IT
  • 9Department Of Medical Oncology, Cro National Institute for Cancer Research, Aviano/IT
  • 10Medical Oncology, Civil Hospital, Mirano/IT
  • 11Medical Oncology, Fondazione Poliambulanza, Brescia/IT
  • 12Medical Oncology, Fondazione Campanella, Catanzaro/IT
  • 13Medical Oncology, Ospedale, Castelfranco Veneto/IT
  • 14Medical Oncology, Ospedale, Montecchio Maggiore/IT
  • 15Medical Oncology, Ospedale, Thiene/IT
  • 16Medical Oncology, Ospedale, Belluno/IT
  • 17Medical Oncology, Presidio Ospedaliero Ulss 17, Este/IT
  • 18Medical Oncology, Ospedale Civile, Feltre/IT
  • 19Medical Oncology, Dr. Michele Medici, Mestre/IT
  • 20Medical Oncology, Osp. Santa Maria Misericordia, Rovigo/IT

Abstract

Aim

Limited information is still available on the role of TT for mRCC in elderly pts to inform their use in clinical practice.

Methods

Individual data of 1238 pts treated with TT from mid 2007 to December 2012 were obtained from 35 Italian Institutions; this study reports about the 455 pts over 70 (36.7%).

Results

Median age was 75 yrs (range 70-91). Comorbidities were 0-1 in 49%, 2 in 23%, 3 in 11%, >4 in 12% of the pts, the most frequent being hypertension (48%), cardiac (25%), metabolic (16%), diabetes (15%), gastrointestinal (11%), other malignancy (9%). Median overall survival (mOS) was 22 mo. 1st line (ln) treatment (tx) was: sunitinib (su) 74%, sorafenib (so) 15.5%, temsirolimus (tem) 5%, others (5.5%). mOS was 26.7 for su, 21 for so (p= NS) and 4 for tem. Median 1st ln PFS was 9.8 mo: su 12.3, so 7.2 (su vs so: p= 0.02), tem 1.9 (so vs tem: p > 0.001). Disease control rate was 64% (293 pts). Toxicities for su/so (% of all grades) were as follows: mucosites (42/31), hypertension (41/25), haematological (54/4), diarrhea (14/25), fatigue (50/53), rash (10.5/24), HFS (17/39). Main G3 toxicities were hypertension (11%) and fatigue (8%); G4 were< 1%. Dose reduction and tx interruption were required in 60%-65% and 32%-38% of the pts on su and so, respectively, mostly for toxicity (44%) or prudential reasons/declining PS (21%). 206 pts (45%) received 2nd ln tx. OS from starting 2nd ln tx was 15.4 mo. mPFS of 2nd ln was 3.3 mo: su 4.5, everolimus 4, so 3, other 2.7 (eve vs so: p= 0.02; su vs so: p= 0.045). Good PS, nephrectomy, duration of 1st line tx > 6 mo were statistically related to execution of 2nd line tx at logistic regression. At Cox multivariate analysis, CC histology, nephrectomy, good PS, response, duration of 1st ln tx >6 mo, execution of 2nd ln tx were favourable prognostic factors for OS. 73 pts (16%) received 3 or more lines of tx: mOS of this group was 39 mo.

Conclusions

This survey shows that i) TT were feasible in elderly, ii) outcome and toxicities were comparable to those of younger pts, iii) CC histology, nephrectomy, good PS, response to 1st ln tx, duration of 1st ln tx >6 mo, execution of 2nd ln tx were favourable prognostic factors for OS.

Disclosure

All authors have declared no conflicts of interest.