Asunto(s)
Adenocarcinoma Mucinoso/diagnóstico , Neoplasias del Colon/diagnóstico , Metástasis Linfática/diagnóstico por imagen , Recurrencia Local de Neoplasia/diagnóstico , Trombosis de la Vena/diagnóstico por imagen , Adenocarcinoma Mucinoso/complicaciones , Adenocarcinoma Mucinoso/terapia , Anticoagulantes/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Camptotecina/análogos & derivados , Camptotecina/uso terapéutico , Quimioterapia Adyuvante , Colectomía , Neoplasias del Colon/complicaciones , Neoplasias del Colon/terapia , Fluorouracilo/uso terapéutico , Humanos , Leucovorina/uso terapéutico , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Metástasis Linfática/patología , Masculino , Venas Mesentéricas/diagnóstico por imagen , Venas Mesentéricas/patología , Venas Mesentéricas/cirugía , Mesenterio/irrigación sanguínea , Mesenterio/diagnóstico por imagen , Mesenterio/patología , Persona de Mediana Edad , Invasividad Neoplásica/diagnóstico por imagen , Invasividad Neoplásica/patología , Recurrencia Local de Neoplasia/complicaciones , Recurrencia Local de Neoplasia/tratamiento farmacológico , Compuestos Organoplatinos/uso terapéutico , Tomografía Computarizada por Tomografía de Emisión de Positrones , Trombectomía , Resultado del Tratamiento , Trombosis de la Vena/etiología , Trombosis de la Vena/terapiaRESUMEN
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.