Miyake Hideaki, Harada Ken-Ichi, Ozono Seiichiro, Fujisawa Masato
Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan.
Med Oncol. 2016 Aug;33(8):95. doi: 10.1007/s12032-016-0813-1. Epub 2016 Jul 21.
The objective of this study was to analyze the impact of age on clinical outcomes of metastatic renal cell carcinoma (mRCC) patients receiving axitinib. This study included 144 consecutive mRCC patients who received axitinib for at least 12 weeks as second-line therapy in a routine clinical setting. The efficacy, safety and quality of life (QOL) were compared between patients aged <75 (n = 116) and ≥75 (n = 28) years. No significant differences in the clinicopathological characteristics were noted between younger and older patients. There was no significant difference in the response rate, clinical benefit rate or proportion of patients going on to receive third-line therapy between these two groups. In addition, the progression-free and overall survivals in older patients were similar to those in younger patients. There were no significant differences in the incidences of adverse events between these two groups, except for that of fatigue, which was significantly more frequent in older than younger patients. There was no significant difference in the incidence of the discontinuation of axitinib due to adverse events between the two groups. QOL assessment at 12 weeks after the introduction of axitinib using the Medical Outcomes Study 36-Item Short Form showed no significant differences in any of the eight scale scores between the two groups. Taken together, it might be possible to achieve clinical outcomes in older patients receiving axitinib comparable to those in younger patients, suggesting that advanced age should not be a contraindication to treatment with axitinib as a second-line setting in mRCC patients.
本研究的目的是分析年龄对接受阿昔替尼治疗的转移性肾细胞癌（mRCC）患者临床结局的影响。本研究纳入了144例连续的mRCC患者，这些患者在常规临床环境中接受阿昔替尼作为二线治疗至少12周。比较了年龄<75岁（n = 116）和≥75岁（n = 28）的患者之间的疗效、安全性和生活质量（QOL）。年轻患者和老年患者之间的临床病理特征无显著差异。两组之间的缓解率、临床获益率或接受三线治疗的患者比例无显著差异。此外，老年患者的无进展生存期和总生存期与年轻患者相似。两组之间不良事件的发生率无显著差异，除了疲劳，老年患者的疲劳发生率明显高于年轻患者。两组之间因不良事件而停用阿昔替尼的发生率无显著差异。使用医学结局研究36项简表在引入阿昔替尼后12周进行的QOL评估显示，两组之间的八个量表评分中的任何一个均无显著差异。综上所述，接受阿昔替尼治疗的老年患者可能获得与年轻患者相当的临床结局，这表明高龄不应成为mRCC患者二线使用阿昔替尼治疗的禁忌证。
