Patterns of care for metastatic renal cell carcinoma in Australia

Daphne Day, Yada Kanjanapan, Edmond Kwan, Desmond Yip, Nathan Lawrentschuk, Miles C Andrews, Ian Davis, Arun Azad, Mark Andrew Rosenthal, Shirley Wong, A L Johnstone, Peter Gibbs, Ben Tran

Research output: Contribution to journalArticleResearchpeer-review

Abstract

OBJECTIVE: To examine the patterns of care and outcomes for metastatic renal cell carcinoma (mRCC) in Australia, where there are limited reimbursed treatment options. In particular, we aim to explore prescribing patterns for first-line systemic treatment, the practice of an initial watchful-waiting approach, and the use of systemic treatments in elderly patients. SUBJECTS/PATIENTS AND METHODS: Patients with mRCC undergoing treatment between 2006 and 2012 were identified from four academic hospitals in Victoria and Australian Capital Territory. Demographic, clinicopathological, treatment, and survival data were recorded by chart review. Descriptive statistics were used to report findings. Survival was estimated by the Kaplan-Meier method and compared using the log-rank test. The study was supported by a grant from Pfizer Australia. RESULTS: Our study identified 212 patients with mRCC for analysis. Patients were predominantly of clear cell histology (75 ), Eastern Cooperative Oncology Group performance status 90 days before initiating treatment; these patients had a median OS of 56.3 months. Elderly patients (50 patients aged >/=70 years) were more likely to receive BSC alone than younger patients (46 vs 16 , P <0.001). Of those who received systemic therapy, elderly patients were also more likely to have upfront dose reductions (30 vs 8 , P = 0.03). CONCLUSION: Our study of patients with mRCC treated in Australian centres showed that sunitinib was the most commonly prescribed systemic treatment between 2006 and 2012, associated with survival outcomes similar to pivotal studies. We also found that an initial watchful-waiting approach is commonly adopted without apparent detriment to survival. And finally, we found that age has an impact on the prescribing of systemic therapy.
Original languageEnglish
Pages (from-to)36 - 41
Number of pages6
JournalBJU International
Volume116
DOIs
Publication statusPublished - 2015

Cite this

Day, D., Kanjanapan, Y., Kwan, E., Yip, D., Lawrentschuk, N., Andrews, M. C., ... Tran, B. (2015). Patterns of care for metastatic renal cell carcinoma in Australia. BJU International, 116, 36 - 41. https://doi.org/10.1111/bju.13176
Day, Daphne ; Kanjanapan, Yada ; Kwan, Edmond ; Yip, Desmond ; Lawrentschuk, Nathan ; Andrews, Miles C ; Davis, Ian ; Azad, Arun ; Rosenthal, Mark Andrew ; Wong, Shirley ; Johnstone, A L ; Gibbs, Peter ; Tran, Ben. / Patterns of care for metastatic renal cell carcinoma in Australia. In: BJU International. 2015 ; Vol. 116. pp. 36 - 41.
@article{2ab939c0954a42479f2c9b485908a3ad,
title = "Patterns of care for metastatic renal cell carcinoma in Australia",
abstract = "OBJECTIVE: To examine the patterns of care and outcomes for metastatic renal cell carcinoma (mRCC) in Australia, where there are limited reimbursed treatment options. In particular, we aim to explore prescribing patterns for first-line systemic treatment, the practice of an initial watchful-waiting approach, and the use of systemic treatments in elderly patients. SUBJECTS/PATIENTS AND METHODS: Patients with mRCC undergoing treatment between 2006 and 2012 were identified from four academic hospitals in Victoria and Australian Capital Territory. Demographic, clinicopathological, treatment, and survival data were recorded by chart review. Descriptive statistics were used to report findings. Survival was estimated by the Kaplan-Meier method and compared using the log-rank test. The study was supported by a grant from Pfizer Australia. RESULTS: Our study identified 212 patients with mRCC for analysis. Patients were predominantly of clear cell histology (75 ), Eastern Cooperative Oncology Group performance status 90 days before initiating treatment; these patients had a median OS of 56.3 months. Elderly patients (50 patients aged >/=70 years) were more likely to receive BSC alone than younger patients (46 vs 16 , P <0.001). Of those who received systemic therapy, elderly patients were also more likely to have upfront dose reductions (30 vs 8 , P = 0.03). CONCLUSION: Our study of patients with mRCC treated in Australian centres showed that sunitinib was the most commonly prescribed systemic treatment between 2006 and 2012, associated with survival outcomes similar to pivotal studies. We also found that an initial watchful-waiting approach is commonly adopted without apparent detriment to survival. And finally, we found that age has an impact on the prescribing of systemic therapy.",
author = "Daphne Day and Yada Kanjanapan and Edmond Kwan and Desmond Yip and Nathan Lawrentschuk and Andrews, {Miles C} and Ian Davis and Arun Azad and Rosenthal, {Mark Andrew} and Shirley Wong and Johnstone, {A L} and Peter Gibbs and Ben Tran",
year = "2015",
doi = "10.1111/bju.13176",
language = "English",
volume = "116",
pages = "36 -- 41",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",

}

Day, D, Kanjanapan, Y, Kwan, E, Yip, D, Lawrentschuk, N, Andrews, MC, Davis, I, Azad, A, Rosenthal, MA, Wong, S, Johnstone, AL, Gibbs, P & Tran, B 2015, 'Patterns of care for metastatic renal cell carcinoma in Australia' BJU International, vol. 116, pp. 36 - 41. https://doi.org/10.1111/bju.13176

Patterns of care for metastatic renal cell carcinoma in Australia. / Day, Daphne; Kanjanapan, Yada; Kwan, Edmond; Yip, Desmond; Lawrentschuk, Nathan; Andrews, Miles C; Davis, Ian; Azad, Arun; Rosenthal, Mark Andrew; Wong, Shirley; Johnstone, A L; Gibbs, Peter; Tran, Ben.

In: BJU International, Vol. 116, 2015, p. 36 - 41.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Patterns of care for metastatic renal cell carcinoma in Australia

AU - Day, Daphne

AU - Kanjanapan, Yada

AU - Kwan, Edmond

AU - Yip, Desmond

AU - Lawrentschuk, Nathan

AU - Andrews, Miles C

AU - Davis, Ian

AU - Azad, Arun

AU - Rosenthal, Mark Andrew

AU - Wong, Shirley

AU - Johnstone, A L

AU - Gibbs, Peter

AU - Tran, Ben

PY - 2015

Y1 - 2015

N2 - OBJECTIVE: To examine the patterns of care and outcomes for metastatic renal cell carcinoma (mRCC) in Australia, where there are limited reimbursed treatment options. In particular, we aim to explore prescribing patterns for first-line systemic treatment, the practice of an initial watchful-waiting approach, and the use of systemic treatments in elderly patients. SUBJECTS/PATIENTS AND METHODS: Patients with mRCC undergoing treatment between 2006 and 2012 were identified from four academic hospitals in Victoria and Australian Capital Territory. Demographic, clinicopathological, treatment, and survival data were recorded by chart review. Descriptive statistics were used to report findings. Survival was estimated by the Kaplan-Meier method and compared using the log-rank test. The study was supported by a grant from Pfizer Australia. RESULTS: Our study identified 212 patients with mRCC for analysis. Patients were predominantly of clear cell histology (75 ), Eastern Cooperative Oncology Group performance status 90 days before initiating treatment; these patients had a median OS of 56.3 months. Elderly patients (50 patients aged >/=70 years) were more likely to receive BSC alone than younger patients (46 vs 16 , P <0.001). Of those who received systemic therapy, elderly patients were also more likely to have upfront dose reductions (30 vs 8 , P = 0.03). CONCLUSION: Our study of patients with mRCC treated in Australian centres showed that sunitinib was the most commonly prescribed systemic treatment between 2006 and 2012, associated with survival outcomes similar to pivotal studies. We also found that an initial watchful-waiting approach is commonly adopted without apparent detriment to survival. And finally, we found that age has an impact on the prescribing of systemic therapy.

AB - OBJECTIVE: To examine the patterns of care and outcomes for metastatic renal cell carcinoma (mRCC) in Australia, where there are limited reimbursed treatment options. In particular, we aim to explore prescribing patterns for first-line systemic treatment, the practice of an initial watchful-waiting approach, and the use of systemic treatments in elderly patients. SUBJECTS/PATIENTS AND METHODS: Patients with mRCC undergoing treatment between 2006 and 2012 were identified from four academic hospitals in Victoria and Australian Capital Territory. Demographic, clinicopathological, treatment, and survival data were recorded by chart review. Descriptive statistics were used to report findings. Survival was estimated by the Kaplan-Meier method and compared using the log-rank test. The study was supported by a grant from Pfizer Australia. RESULTS: Our study identified 212 patients with mRCC for analysis. Patients were predominantly of clear cell histology (75 ), Eastern Cooperative Oncology Group performance status 90 days before initiating treatment; these patients had a median OS of 56.3 months. Elderly patients (50 patients aged >/=70 years) were more likely to receive BSC alone than younger patients (46 vs 16 , P <0.001). Of those who received systemic therapy, elderly patients were also more likely to have upfront dose reductions (30 vs 8 , P = 0.03). CONCLUSION: Our study of patients with mRCC treated in Australian centres showed that sunitinib was the most commonly prescribed systemic treatment between 2006 and 2012, associated with survival outcomes similar to pivotal studies. We also found that an initial watchful-waiting approach is commonly adopted without apparent detriment to survival. And finally, we found that age has an impact on the prescribing of systemic therapy.

UR - http://onlinelibrary.wiley.com/doi/10.1111/bju.13176/epdf

U2 - 10.1111/bju.13176

DO - 10.1111/bju.13176

M3 - Article

VL - 116

SP - 36

EP - 41

JO - BJU International

JF - BJU International

SN - 1464-4096

ER -

Day D, Kanjanapan Y, Kwan E, Yip D, Lawrentschuk N, Andrews MC et al. Patterns of care for metastatic renal cell carcinoma in Australia. BJU International. 2015;116:36 - 41. https://doi.org/10.1111/bju.13176