title: Patient approach in advanced/metastatic renal cell carcinoma: focus on the elderly population and treatment-related toxicity.
abstract: Recent therapeutic advances have changed the treatment landscape of metastatic renal cell carcinoma. Unfortunately, the seven agents now available are not based on biomarkers that would indicate which one could provide the best benefit for every patient. We have reviewed the avaliable information concerning the impact of each treatment on comorbidities or status that are frequently seen before commencing treatment for the advanced disease: elderly and patients with cardiovascular complications, metabolic and endocrinology disorders, and infections, as well as impaired organ function (kidney, liver and heart). Additional new drugs will be launched, but no predictive biomarkers are available. Head-to-head studies to evaluate the safety of the different drugs are rare. In this quite complex scenario, we believe that a decision-making approach focused on the patient may represent a suitable strategy.
authors.affiliation: Department of Medical Oncology, Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, 20133, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Verzoni
authors.forename: Filippo
authors.initials: F
authors.lastname: de Braud
authors.forename: Francesca
authors.initials: F
authors.lastname: Fabiani
authors.forename: Paolo
authors.initials: P
authors.lastname: Grassi
authors.forename: Isabella
authors.initials: I
authors.lastname: Testa
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008099:Liver / Q000187:drug effects / Q000503:physiopathology; D008171:Lung Diseases / Q000139:chemically induced / Q000382:microbiology
chemical_list: D000970:Antineoplastic Agents