Model Developed for Predicting Toxicity-related Treatment Discontinuation in mRCC

Independent risk factors for toxicity-related treatment discontinuation (TrTD) in patients with metastatic renal cell carcinoma (mRCC).
Independent risk factors for toxicity-related treatment discontinuation (TrTD) in patients with metastatic renal cell carcinoma (mRCC).

Researchers identified the independent risk factors for toxicity-related treatment discontinuation (TrTD) in patients with metastatic renal cell carcinoma (mRCC) and built a tool for predicting TrTD in clinical practice. These results were published online ahead of print in the journal Cancer.1

Vascular endothelial growth factor (VEGF)-targeted therapy is the standard treatment for patients with mRCC; however, toxicities that lead to drug discontinuation are a concerning issue for patients with mRCC, as they have a significant impact on patient outcomes.

In this largest series to date, researchers collected data from the International Metastatic Renal Cell Carcinoma Database Consortium on baseline characteristics, treatment outcomes, and toxicity for 936 patients with mRCC receiving first-line VEGF-targeted therapy. Using a competing risk regression model identified risk factors for TrTD, also accounting for other causes as competing risks.

The most common VEGF-targeted therapy was sunitinib (77%), followed by sorafenib (18.4%); median duration of treatment was 7.1 months for all patients. Overall, 198 patients (23.8%) experienced TrTD, and median duration of treatment for these patients was 4.4 months.

Toxicities that most commonly lead to treatment discontinuation were fatigue, diarrhea, and mucositis. Significant predictors for TrTD included baseline age 60 years or older, glomerular filtration rate less than 30 mL/min/1.73m2, a single metastatic site, and sodium level less than 135 mmol/L. The risk group model developed used the number of patient risk factors to predict TrTD risk.

REFERENCE

1. Kaymakcalan MD, Xie W, Albiges L, et al. Risk factors and model for predicting toxicity-related treatment discontinuation in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy: results from the International Metastatic Renal Cell Carcinoma Database Consortium [published online ahead of print November 5, 2015]. Cancer. doi:10.1002/cncr.29773.

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