title: Anti-VEGF therapy in mRCC: differences between Asian and non-Asian patients.
abstract: BACKGROUND
  Several reports suggest that vascular endothelial growth factor (VEGF)-targeted therapy in metastatic renal cell carcinoma (mRCC) may be more toxic in Asian vs non-Asian populations. Comparative efficacy of these agents with respect to ethnicity is not well characterised.
  
  
  METHODS
  A multicentre, retrospective, cohort study using Asian and non-Asian centres which collected data on ethnicity, dose reductions and outcomes using the International mRCC Database Consortium.
  
  
  RESULTS
  This study included 1024 (464 Asian, 560 non-Asian) patients with a 29.4 months median follow-up. The percentage of dose modifications/reductions between non-Asians and Asians was similar (55% vs 61% P=0.1197). When adjusted for risk groups, there was no difference in overall or progression-free survival between non-Asians and Asians. Patients with dose reductions due to toxicity had longer treatment durations and overall survival than those who did not in both non-Asian (10.6 vs 5.0 months, P<0.0001; 22.6 vs 16.1 months, P=0.0016, respectively) and Asian populations (8.9 vs 5.4 months, P=0.0028; 28.0 vs 18.7 months, P=0.0069, respectively).
  
  
  CONCLUSIONS
  Adjusting for risk groups, there appears to be no difference in outcome between Asian vs non-Asian patients with mRCC treated with VEGF-targeted therapy. Judicious dose reductions may allow for better outcomes in both populations due to longer treatment durations, but direct comparisons are needed.
authors.affiliation: University of Calgary, Calgary, Alberta, Canada.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Kidney Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: T K
authors.initials: TK
authors.lastname: Choueiri
authors.affiliation: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: J-L
authors.initials: JL
authors.lastname: Lee
authors.affiliation: National Cancer Centre, Singapore, Singapore.
authors.forename: M-H
authors.initials: MH
authors.lastname: Tan
authors.affiliation: Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Rha
authors.affiliation: Cross Cancer Institute, Edmonton, Alberta, Canada.
authors.forename: S A
authors.initials: SA
authors.lastname: North
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: C K
authors.initials: CK
authors.lastname: Kollmannsberger
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Massachusetts, USA.
authors.forename: D F
authors.initials: DF
authors.lastname: McDermott
authors.affiliation: Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: D Y C
authors.initials: DY
authors.lastname: Heng
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D044466:Asian People; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000208:ethnology* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000208:ethnology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A