Angiogenesis inhibitor therapies for advanced renal cell carcinoma: Toxicity and treatment patterns in clinical practice from a global medical chart review

作者：Oh William K; McDermott David; Porta Camillo; Levy Antonin; Elaidi Reza; Scotte Florian; Hawkins Robert; Castellano Daniel; Bellmunt Joaquim; Rha Sun Young; Sun Jong Mu; Nathan Paul; Feinberg Bruce A; Scott Jeffrey; McDermott Ray; Ahn Jin Hee; Wagstaff John; Chang Yen Hwa; Ou Yen Chuan; Donnellan Paul; Huang Chao Yuan; McCaffrey John; Chiang Po Hui; Chuang Cheng Keng; Korves Caroline; Neary Maureen P; Diaz Jose R; Mehmud Faisal; Duh Mei Sheng^*

来源：International Journal of Oncology, 2014, 44(1): 5-16.

DOI：10.3892/ijo.2013.2181

• renal cell carcinoma
• angiogenesis inhibitors
• safety
• treatment patterns
• interruption
• dose reduction

The aim of this study was to assess the treatment patterns and safety of sunitinib, sorafenib and bevacizumab in real-world clinical settings in US, Europe and Asia. Medical records were abstracted at 18 community oncology clinics in the US and at 21 tertiary oncology centers in US, Europe and Asia for 883 patients 18 years who had histologically/cytologically confirmed diagnosis of advanced RCC and received sunitinib (n=631), sorafenib (n=207) or bevacizumab (n=45) as first-line treatment. No prior treatment was permitted. Data were collected on all adverse events (AEs) and treatment modifications, including discontinuation, interruption and dose reduction. Treatment duration was estimated using Kaplan-Meier analysis. Demographics were similar across treatment groups and regions. Median treatment duration ranged from 6.1 to 10.7 months, 5.1 to 8.5 months and 7.5 to 9.8 months for sunitinib, sorafenib and bevacizumab patients, respectively. Grade 3/4 AEs were experienced by 26.0, 28.0 and 15.6% of sunitinib, sorafenib and bevacizumab patients, respectively. Treatment discontinuations occurred in 62.4 (Asia) to 63.1% (US) sunitinib, 68.8 (Asia) to 90.0% (Europe) sorafenib, and 66.7 (Asia) to 81.8% (US) bevacizumab patients. Globally, treatment modifications due to AEs occurred in 55.1, 54.2 and 50.0% sunitinib, sorafenib and bevacizumab patients, respectively. This study in a large, global cohort of advanced RCC patients found that angiogenesis inhibitors are associated with high rates of AEs and treatment modifications. Findings suggest an unmet need for more tolerable agents for RCC treatment.

• 出版日期2014-1