title: Efficacy and safety of sunitinib in elderly patients with metastatic renal cell carcinoma.
abstract: BACKGROUND
  We retrospectively analyzed sunitinib outcome as a function of age in metastatic renal cell carcinoma (mRCC) patients.
  
  
  METHODS
  Data were pooled from 1059 patients in six trials. Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS) were compared by log-rank test between patients aged <70 (n=857; 81%) and ≥70 (n=202; 19%) years.
  
  
  RESULTS
  In first-line patients, median PFS was comparable in younger and older patients, 9.9 vs 11.0 months, respectively (HR, 0.89; 95% CI: 0.73-1.09; P=0.2629), as was median OS, 23.6 vs 25.6 months (HR, 0.93; 95% CI: 0.74-1.18; P=0.5442). Similarly, in cytokine-refractory patients, median PFS was 8.1 vs 8.4 months (HR, 0.79; 95% CI: 0.49-1.28; P=0.3350), while median OS was 20.2 vs 15.8 months (HR, 1.14; 95% CI: 0.73-1.79; P=0.5657). Some treatment-emergent adverse events were significantly less common in younger vs older patients, including fatigue (60% vs 69%), cough (20% vs 29%), peripheral edema (17% vs 27%), anemia (18% vs 25%), decreased appetite (13% vs 29%), and thrombocytopenia (16% vs 25%; all P<0.05). Hand-foot syndrome was more common in younger patients (32% vs 24%).
  
  
  CONCLUSIONS
  Advanced age should not be a deterrent to sunitinib therapy and elderly patients may achieve additional clinical benefit.
authors.affiliation: Baylor Sammons Cancer Center-Texas Oncology, PA, Dallas, TX, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: Hutson
authors.affiliation: Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Bukowski
authors.affiliation: Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.
authors.forename: B I
authors.initials: BI
authors.lastname: Rini
authors.affiliation: Royal Marsden Hospital NHS Trust, London, UK.
authors.forename: M E
authors.initials: ME
authors.lastname: Gore
authors.affiliation: Royal Marsden Hospital NHS Trust, London, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Larkin
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Figlin
authors.affiliation: PUCRS School of Medicine, Porto Alegre, Brazil.
authors.forename: C H
authors.initials: CH
authors.lastname: Barrios
authors.affiliation: Institut Gustave Roussy, Villejuif, France.
authors.forename: B
authors.initials: B
authors.lastname: Escudier
authors.affiliation: Pfizer Oncology, La Jolla, CA, USA.
authors.forename: X
authors.initials: X
authors.lastname: Lin
authors.affiliation: Pfizer Oncology, Groton, CT, USA.
authors.forename: K
authors.initials: K
authors.lastname: Fly
authors.affiliation: Pfizer Oncology, New York, NY, USA.
authors.forename: B
authors.initials: B
authors.lastname: Martell
authors.affiliation: Pfizer Oncology, New York, NY, USA.
authors.forename: E
authors.initials: E
authors.lastname: Matczak
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Motzer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D017326:Clinical Trials, Phase III as Topic; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D000077210:Sunitinib; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib