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Advanced kidney cancer: treating the elderly

Fable Zustovich1, Giacomo Novara

  • 1IRCCS Istituto Oncologico Veneto, Medical Oncology, Via Gattamelata, 64-35128 Padua, Italy.

Expert Review of Anticancer Therapy
|November 15, 2013
PubMed

Insights

Elderly patients with kidney tumors are underrepresented in clinical trials. This study proposes a new approach to select optimal cancer treatments for older adults, considering their unique health factors.

Area of Science:

  • Oncology
  • Geriatrics
  • Nephrology

Background:

  • Advancing age is the primary risk factor for renal tumors.
  • Elderly patients are underrepresented in clinical trials for renal cell carcinoma treatments.
  • Current opinions on nephrectomy for elderly patients are conflicting.

Purpose of the Study:

  • To address the lack of representation of elderly patients in clinical trials for renal tumors.
  • To evaluate the efficacy and safety of existing treatments in older populations.
  • To propose a novel decision-making algorithm for selecting kidney tumor therapies in elderly patients.

Main Methods:

  • Reviewing available efficacy and safety data for angiogenesis inhibitors in patients aged 65 and older.
  • Analyzing data for specific drugs (sunitinib, sorafenib, everolimus) in patients aged 70 and older.
  • Considering comorbidities, drug interactions, and polytherapy regimens in elderly patients.

Main Results:

  • Limited safety and efficacy data exist for elderly patients, especially those over 70 and 75.
  • Sorafenib has the most available safety data for patients aged 75 and older.
  • A comprehensive approach evaluating patient-specific factors is needed.

Conclusions:

  • Existing clinical trial data inadequately represents elderly patients with renal tumors.
  • A tailored approach considering comorbidities and polytherapy is crucial for treatment selection.
  • The proposed decision-making algorithm aims to optimize kidney tumor therapy for individual elderly patients.

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