PMID- 25498215
OWN - NLM
STAT- MEDLINE
DCOM- 20160128
LR  - 20211203
IS  - 1938-0682 (Electronic)
IS  - 1558-7673 (Linking)
VI  - 13
IP  - 3
DP  - 2015 Jun
TI  - First-Line and Sequential Use of Pazopanib Followed by Mammalian Target of 
      Rapamycin Inhibitor Therapy Among Patients With Advanced Renal Cell Carcinoma in 
      a US Community Oncology Setting.
PG  - 210-7
LID - S1558-7673(14)00252-3 [pii]
LID - 10.1016/j.clgc.2014.11.001 [doi]
AB  - BACKGROUND: Clinical trials have demonstrated that pazopanib prolongs 
      progression-free survival (PFS), with an acceptable safety profile, for patients 
      with advanced renal cell carcinoma (aRCC). The efficacy of second-line mammalian 
      target of rapamycin (mTOR) inhibitors in pazopanib-treated patients has also been 
      evaluated in clinical trials; however, few studies have evaluated first-line 
      pazopanib or second-line mTOR inhibitors in real-world settings. The present 
      study evaluated the outcomes of first-line pazopanib, and pazopanib followed by 
      mTOR inhibitors, in a community oncology setting. PATIENTS AND METHODS: The 
      present study was a retrospective analysis of eligible patients in US Oncology's 
      iKnowMed electronic health records database who had been treated for aRCC from 
      November 1, 2009 to August 31, 2012. The patients received first-line therapy 
      with pazopanib (cohort 1), followed by second-line therapy with either everolimus 
      or temsirolimus (cohort 2). The key outcomes included overall survival (OS), PFS, 
      adverse events (AEs), treatment patterns, and healthcare resource use. RESULTS: 
      The median OS in cohort 1 (n = 177) was 22 months, and the median PFS was 8.5 
      months. The most common AEs were fatigue (56%), diarrhea (52%), vomiting (44%), 
      and nausea (40%). The median persistence was 151 days with pazopanib. The median 
      OS in cohort 2 (n = 35) was 16 months; the median PFS was 5.7 months. The most 
      common AEs were fatigue (51%) and nausea (34%). The median persistence was 93 
      days with everolimus and 49 days with temsirolimus. CONCLUSION: The outcomes for 
      the patients treated with first-line pazopanib in the community setting were 
      consistent with those reported by previous prospective and retrospective studies. 
      Although the second-line cohort was small, the results of mTOR inhibitors after 
      pazopanib were also consistent with those of previous observations.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Vogelzang, Nicholas J
AU  - Vogelzang NJ
AD  - US Oncology Network, McKesson Specialty Health, The Woodlands, TX; Comprehensive 
      Cancer Centers of Nevada, Las Vegas, NV. Electronic address: 
      Nicholas.Vogelzang@usoncology.com.
FAU - Hackshaw, Michelle D
AU  - Hackshaw MD
AD  - GlaxoSmithKline, Collegeville, PA.
FAU - Hutson, Thomas E
AU  - Hutson TE
AD  - US Oncology Network, McKesson Specialty Health, The Woodlands, TX; Texas 
      Oncology-Baylor Sammons Cancer Center, Dallas, TX.
FAU - Bhowmik, Debajyoti
AU  - Bhowmik D
AD  - US Oncology Network, McKesson Specialty Health, The Woodlands, TX.
FAU - Yap, Mark
AU  - Yap M
AD  - US Oncology Network, McKesson Specialty Health, The Woodlands, TX.
FAU - Rembert, Debra
AU  - Rembert D
AD  - US Oncology Network, McKesson Specialty Health, The Woodlands, TX.
FAU - Jonasch, Eric
AU  - Jonasch E
AD  - University of Texas MD Anderson Cancer Center, Houston, TX.
LA  - eng
PT  - Clinical Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141115
PL  - United States
TA  - Clin Genitourin Cancer
JT  - Clinical genitourinary cancer
JID - 101260955
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Indazoles)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Pyrimidines)
RN  - 0 (Sulfonamides)
RN  - 624KN6GM2T (temsirolimus)
RN  - 7RN5DR86CK (pazopanib)
RN  - 9HW64Q8G6G (Everolimus)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angiogenesis Inhibitors/adverse effects/*therapeutic use
MH  - Carcinoma, Renal Cell/*drug therapy/pathology
MH  - Community Networks
MH  - Electronic Health Records
MH  - Everolimus/adverse effects/therapeutic use
MH  - Female
MH  - Humans
MH  - Indazoles
MH  - Kidney Neoplasms/*drug therapy/pathology
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Protein Kinase Inhibitors/adverse effects/*therapeutic use
MH  - Pyrimidines/adverse effects/*therapeutic use
MH  - Retrospective Studies
MH  - Sirolimus/adverse effects/analogs & derivatives/therapeutic use
MH  - Sulfonamides/adverse effects/*therapeutic use
MH  - Survival Analysis
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
MH  - Treatment Outcome
MH  - United States
MH  - Young Adult
OTO - NOTNLM
OT  - Angiogenesis inhibition
OT  - Healthcare resource use
OT  - Real-world outcomes
OT  - Second-line everolimus
OT  - Treatment patterns
EDAT- 2014/12/17 06:00
MHDA- 2016/01/29 06:00
CRDT- 2014/12/16 06:00
PHST- 2014/10/02 00:00 [received]
PHST- 2014/11/11 00:00 [accepted]
PHST- 2014/12/16 06:00 [entrez]
PHST- 2014/12/17 06:00 [pubmed]
PHST- 2016/01/29 06:00 [medline]
AID - S1558-7673(14)00252-3 [pii]
AID - 10.1016/j.clgc.2014.11.001 [doi]
PST - ppublish
SO  - Clin Genitourin Cancer. 2015 Jun;13(3):210-7. doi: 10.1016/j.clgc.2014.11.001. 
      Epub 2014 Nov 15.