PMID- 25045157
OWN - NLM
STAT- MEDLINE
DCOM- 20150923
LR  - 20211021
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Print)
IS  - 2045-7634 (Linking)
VI  - 3
IP  - 6
DP  - 2014 Dec
TI  - Impact of adverse events, treatment modifications, and dose intensity on survival 
      among patients with advanced renal cell carcinoma treated with first-line 
      sunitinib: a medical chart review across ten centers in five European countries.
PG  - 1517-26
LID - 10.1002/cam4.302 [doi]
AB  - Angiogenesis inhibitors have become standard of care for advanced and/or 
      metastatic renal cell carcinoma (RCC), but data on the impact of adverse events 
      (AEs) and treatment modifications associated with these agents are limited. 
      Medical records were abstracted at 10 tertiary oncology centers in Europe for 291 
      patients >/= 18 years old treated with sunitinib as first-line treatment for 
      advanced RCC (no prior systemic treatment for advanced disease). Logistic 
      regression models were estimated to compare dose intensity among patients who did 
      and did not experience AEs during the landmark periods (18, 24, and 30 weeks). 
      Cox proportional hazard models were used to explore the possible relationship of 
      low-dose intensity (defined using thresholds of 0.7, 0.8, and 0.9) and treatment 
      modifications during the landmark periods to survival. 64.4% to 67.9% of patients 
      treated with sunitinib reported at least one AE of any grade, and approximately 
      10% of patients experienced at least one severe (grade 3 or 4) AE. Patients 
      reporting severe AEs were statistically significantly more likely to have dose 
      intensities below either 0.8 or 0.9. Dose intensity below 0.7 and dose 
      discontinuation during all landmark periods were statistically significantly 
      associated with shorter survival time. This study of advanced RCC patients 
      treated with sunitinib in Europe found a significant relationship between AEs and 
      dose intensity. It also found correlations between dose intensity and shorter 
      survival, and between dose discontinuation and shorter survival. These results 
      confirm the importance of tolerable treatment and maintaining dose intensity.
CI  - (c) 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Porta, Camillo
AU  - Porta C
AD  - IRCCS San Matteo University Hospital Foundation, Pavia, Italy.
FAU - Levy, Antonin
AU  - Levy A
FAU - Hawkins, Robert
AU  - Hawkins R
FAU - Castellano, Daniel
AU  - Castellano D
FAU - Bellmunt, Joaquim
AU  - Bellmunt J
FAU - Nathan, Paul
AU  - Nathan P
FAU - McDermott, Ray
AU  - McDermott R
FAU - Wagstaff, John
AU  - Wagstaff J
FAU - Donnellan, Paul
AU  - Donnellan P
FAU - McCaffrey, John
AU  - McCaffrey J
FAU - Vekeman, Francis
AU  - Vekeman F
FAU - Neary, Maureen P
AU  - Neary MP
FAU - Diaz, Jose
AU  - Diaz J
FAU - Mehmud, Faisal
AU  - Mehmud F
FAU - Duh, Mei Sheng
AU  - Duh MS
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140718
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Indoles)
RN  - 0 (Pyrroles)
RN  - V99T50803M (Sunitinib)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiogenesis Inhibitors/*administration & dosage/*adverse effects
MH  - Carcinoma, Renal Cell/blood supply/*drug therapy/pathology
MH  - Cohort Studies
MH  - Europe
MH  - Female
MH  - Humans
MH  - Indoles/*administration & dosage/*adverse effects
MH  - Kidney Neoplasms/blood supply/*drug therapy/pathology
MH  - Male
MH  - Middle Aged
MH  - Pyrroles/*administration & dosage/*adverse effects
MH  - Retrospective Studies
MH  - Sunitinib
MH  - Survival Analysis
PMC - PMC4298378
OTO - NOTNLM
OT  - Angiogenesis
OT  - clinical observations
OT  - statistical methods
OT  - urological oncology
EDAT- 2014/07/22 06:00
MHDA- 2015/09/24 06:00
PMCR- 2014/12/01
CRDT- 2014/07/22 06:00
PHST- 2014/02/20 00:00 [received]
PHST- 2014/06/17 00:00 [revised]
PHST- 2014/06/24 00:00 [accepted]
PHST- 2014/07/22 06:00 [entrez]
PHST- 2014/07/22 06:00 [pubmed]
PHST- 2015/09/24 06:00 [medline]
PHST- 2014/12/01 00:00 [pmc-release]
AID - 10.1002/cam4.302 [doi]
PST - ppublish
SO  - Cancer Med. 2014 Dec;3(6):1517-26. doi: 10.1002/cam4.302. Epub 2014 Jul 18.