title: Impact of age on treatment trends and clinical outcome in  patients with metastatic renal cell carcinoma.
abstract: OBJECTIVE
  Clinical outcomes in older adults with metastatic renal cell carcinoma (mRCC) are poorly understood, particularly in the era of targeted therapies. We characterize survival and relevant treatment-related variables in a modern series.
  
  
  METHODS
  From an institutional database including 562 patients with RCC, a total of 219 patients with metastatic disease were identified for the current analysis. Survival was assessed in four age-based cohorts: (1) age<55, (2) age 55–64, (3) age 65–74, and(4) age≥75. The number of lines of therapy rendered was collected for each patient, and the reason for treatment discontinuation was characterized.
  
  
  RESULTS
  Of the 219 patients assessed, median age was 58 (range, 26–87), and most patients had clear cell histology (82%) and prior nephrectomy (70.9%). The majority of patients were characterized as intermediate-risk (53%) by MSKCC criteria. Median survival in patients age≥75 was 12.5 months, as compared to 26.4 months for patients age<75 (P=0.003). Patients age≥75 received fewer lines of systemic therapy as compared to other age-based subsets, and more frequently discontinued therapies due to toxicity.
  
  
  CONCLUSIONS
  Older adults represent a unique subpopulation of patients with mRCC, with distinct clinical outcomes. Further research is warranted to better understand the safety and tolerability of current therapies for mRCC in this group.
authors: Sumanta K
authors: SK
authors: Pal
authors: JoAnn
authors: J
authors: Hsu
authors: Sarah
authors: S
authors: Hsu
authors: Jensen
authors: J
authors: Hu
authors: Paulo
authors: P
authors: Bergerot
authors: Courtney
authors: C
authors: Carmichael
authors: Junmi
authors: J
authors: Saikia
authors: Xueli
authors: X
authors: Liu
authors: Clayton
authors: C
authors: Lau
authors: Przemyslaw
authors: P
authors: Twardowski
authors: Robert A
authors: RA
authors: Figlin
authors: Bertram F
authors: BF
authors: Yuh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007376:Interleukin-2 / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009392:Nephrectomy / Q000706:statistics & numerical data; D011758:Pyrroles / Q000627:therapeutic use; D018570:Risk Assessment; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D007376:Interleukin-2; D011758:Pyrroles; D000077210:Sunitinib
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