Variation in use of targeted therapies for metastatic renal cell carcinoma: Results from a Dutch population-based registryReport as inadecuate




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BMC Cancer

, 16:364

Medical and radiation oncology

Abstract

BackgroundFor patients with metastatic renal cell carcinoma mRCC, targeted therapies have entered the market since 2006. The aims of this study were to evaluate the uptake and use of targeted therapies for mRCC in The Netherlands, examine factors associated with the prescription of targeted therapies in daily clinical practice and study their effectiveness in terms of overall survival OS.

MethodsTwo cohorts from PERCEPTION, a population-based registry of mRCC patients, were used: a 2008–2010 Cohort n = 645 and a 2011–2013 Cohort n = 233. Chi-squared tests for trend were used to study time trends in the use of targeted therapy. Patients were grouped based on the eligibility criteria of the SUTENT trial, the trial that led to sunitinib becoming standard of care, to investigate the use of targeted therapies amongst patients fulfilling those criteria. Multi-level logistic regression was used to identify patient subgroups that are less likely to receive targeted therapies.

ResultsApproximately one-third of patients fulfilling SUTENT trial eligibility criteria did not receive any targeted therapy 29 % in the 2008–2010 Cohort; 35 % in the 2011–2013 Cohort. Patients aged 65+ years were less likely to receive targeted therapy in both cohorts and different risk groups odds ratios range between 0.84–0.92; other factors like number of metastatic sites were of influence in some subgroups. Amongst treated patients, there was a decreasing trend in sunitinib use over time p = 0.0061, and an increasing trend in pazopanib use p = 0.0005.

ConclusionsTargeted therapies have largely replaced interferon-alfa as first-line standard of care. Nevertheless, many eligible patients in Dutch daily practice did not receive targeted therapies despite their ability to improve survival. Reasons for their apparent underutilisation should be examined more carefully.

KeywordsMetastatic renal cell carcinoma Targeted therapy Uptake and use Overall survival Population-based registry Electronic supplementary materialThe online version of this article doi:10.1186-s12885-016-2395-x contains supplementary material, which is available to authorized users.

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Author: S. De Groot - S. Sleijfer - W. K. Redekop - E. Oosterwijk - J. B. A. G. Haanen - L. A. L. M. Kiemeney - C. A. Uyl-d

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