Patterns of treatment (trx) with angiogenesis inhibitors (AIs) in patients (pts) with metastatic renal cell carcinoma (mRCC) in France.

Abstract

e15139 Background: This study evaluated trx patterns of AIs sunitinib (SU), sorafenib (SOR), and bevacizumab (BEV) in a clinical practice setting in France. Methods: Data from medical records were retrospectively reviewed at a tertiary oncology center in France for mRCC pts who were >18 yrs and received SU, SOR or BEV as 1st AI. Proportions of pts with trx discontinuation (d/c), interruption, or dose change were computed. Reasons for trx modifications and AI trx sequences were examined. Results: 121 pts were included (SU n=71, 12 in clinical trial [CT], 5 in expanded access program [EAP]; SOR n=33, 6 in CT, 4 in EAP; BEV n=17, 1 in CT). 8.5% (SU), 24.2% (SOR) and 64.7% (BEV) of pts had received prior cytokine therapy. 88.7% (SU), 97.0% (SOR) and 88.2% (BEV) of pts initiated on the recommended dose. Median 1st-line AI trx duration was 9.1 months (m) (SU), 11.3 m (SOR) and 9.9 m (BEV). Trx d/c occurred in 74.6% (SU), 90.9% (SOR) and 41.2% (BEV) of pts, mostly due to progressive disease (PD) or adverse events (AEs). AEs were the most common reasons for trx interruptions and dose reductions and led to trx modifications in 52.1% (SU), 27.3% (SOR) and 35.3% (BEV) of pts. 38.0% (SU), 54.5% (SOR) and 23.5% (BEV) of pts received 2nd-line AI trx (Table). Conclusions: In clinical practice, toxicity associated with AIs, particularly SU, led to high rates of trx modifications. This study is limited by its retrospective nature and small sample sizes from only a single center. Further exploration of new agents with improved tolerability profiles that may also contribute to improved clinical outcomes is needed for mRCC. Trx patterns, n (%) SU N=71 SOR N=33 BEV N=17 Pts with 1st-line trx d/c 53 (74.6) 30 (90.9) 7 (41.2) Due to PD 36 (50.7) 25 (75.8) 5 (29.4) Due to AEs 11 (15.5) 4 (12.1) 2 (11.8) Pts with 1st-line trx interruption 6 (8.5) 1 (3.0) 2 (11.8) Due to AEs 5 (7.0) 1 (3.0) 2 (11.8) Patients with 1st-line trx dose reduction 28 (39.4) 8 (24.2) 2 (11.8) Due to AEs 28 (39.4) 8 (24.2) 2 (11.8) Pts with ≥1 1st-line trx modification due to AEs 37 (52.1) 9 (27.3) 6 (35.3) Pts with 2nd-line trx 27 (38.0) 18 (54.5) 4 (23.5) Sunitinib 1 (1.4) 18 (54.5) 1 (5.9) Sorafenib 18 (25.4) 0 (0.0) 3 (17.6) Temsirolimus 8 (11.3) 0 (0.0) 0 (0.0) Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration GlaxoSmithKline GlaxoSmithKline, Novartis, Pfizer, Roche GlaxoSmithKline GlaxoSmithKline