title: Safety and treatment patterns of angiogenesis inhibitors in patients with advanced renal cell carcinoma in Spain.
abstract: OBJECTIVE
  To examine real-world safety and treatment patterns of angiogenesis inhibitors for advanced renal cell carcinoma (aRCC) using observational data from two Spanish hospitals.
  
  
  METHODS
  A retrospective medical record review was performed for 93 patients with a histological diagnosis of aRCC who received sunitinib, sorafenib, bevacizumab or temsirolimus as first-line angiogenesis inhibitor therapy, between January 2005 and September 2010 at two Spanish hospitals. Data were collected on adverse events (AEs), dosing to calculate relative dose intensity (RDI), treatment modifications and reasons for modifications.
  
  
  RESULTS
  Sixty patients received sunitinib, 23 received sorafenib, 6 received bevacizumab, 1 received temsirolimus and 3 received a bevacizumab-temsirolimus combination. 91.7 and 100.0% of patients receiving sunitinib and sorafenib, respectively, experienced ≥ 1 AE; 40.0% and 43.5% had ≥ 1 grade 3/4 AE. Mean RDI for sunitinib and sorafenib were 0.866 (standard deviation (std) = 0.903) and 0.798 (std = 2.154), respectively. Among patients receiving sunitinib, 15.0% discontinued treatment, 43.3% had an interruption and 33.3% had a reduction due to AEs. For sorafenib, these rates were 4.3, 56.5 and 34.8%, respectively.
  
  
  CONCLUSIONS
  High rates of AEs were observed which resulted in high rates of treatment interruptions and dose reductions. These results suggest the need for additional treatment options for aRCC with improved tolerability.
authors.affiliation: Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Castellano
authors.forename: Mei Sheng
authors.initials: MS
authors.lastname: Duh
authors.forename: Caroline
authors.initials: C
authors.lastname: Korves
authors.forename: Ellison Dial
authors.initials: ED
authors.lastname: Suthoff
authors.forename: Maureen
authors.initials: M
authors.lastname: Neary
authors.forename: Luis Javier
authors.initials: LJ
authors.lastname: Hernández Pastor
authors.forename: Joaquim
authors.initials: J
authors.lastname: Bellmunt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000098:blood supply* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain
chemical_list: D020533:Angiogenesis Inhibitors