title: Balancing treatment efficacy, toxicity and complication risk in elderly patients with metastatic renal cell carcinoma.
abstract: The number of elderly patients with renal cell carcinoma is rising. Elderly patients differ from their younger counterparts in, among others, higher incidence of comorbidity and reduced organ function. Age influences outcome of surgery, and therefore has to be taken into account in elderly patients eligible for cytoreductive nephrectomy. Over the last decade several novel effective drugs have become available for the metastatic setting targeting angiogenesis and mammalian target of rapamycin. Immune checkpoint blockade with a programmed death 1 antibody has recently been shown to increase survival and further studies with immune checkpoint inhibitors are ongoing. In this review we summarize the available data on efficacy and toxicity of existing and emerging therapies for metastatic renal cell carcinoma in the elderly. Where possible, we provide evidence-based recommendations for treatment choices in elderly.
authors.affiliation: University of Groningen, Department of Medical Oncology, University Medical Center Groningen, The Netherlands.
authors.forename: R R H
authors.initials: RR
authors.lastname: van den Brom
authors.affiliation: University of Groningen, Department of Medical Oncology, University Medical Center Groningen, The Netherlands.
authors.forename: S C
authors.initials: SC
authors.lastname: van Es
authors.affiliation: University of Groningen, Department of Urology, University Medical Center Groningen, The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: Leliveld
authors.affiliation: University of Groningen, Department of Medical Oncology, University Medical Center Groningen, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Gietema
authors.affiliation: University of Groningen, Department of Medical Oncology, University Medical Center Groningen, The Netherlands.
authors.forename: G A P
authors.initials: GA
authors.lastname: Hospers
authors.affiliation: University of Groningen, Department of Urology, University Medical Center Groningen, The Netherlands.
authors.forename: I J
authors.initials: IJ
authors.lastname: de Jong
authors.affiliation: University of Groningen, Department of Medical Oncology, University Medical Center Groningen, The Netherlands.
authors.forename: E G E
authors.initials: EG
authors.lastname: de Vries
authors.affiliation: University of Groningen, Department of Medical Oncology, University Medical Center Groningen, The Netherlands. Electronic address: s.oosting@umcg.nl.
authors.forename: S F
authors.initials: SF
authors.lastname: Oosting
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D009362:Neoplasm Metastasis; D016032:Randomized Controlled Trials as Topic
keywords: Angiogenesis inhibitors; Elderly; Immunotherapy; Mammalian target of rapamycin inhibitors; Nephrectomy; Programmed death 1; Renal cell carcinoma