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Anti-VEGF therapy in mRCC: differences between Asian and non-Asian patients
Y Wang1, T K Choueiri2, J-L Lee3
1University of Calgary, Calgary, Alberta, Canada.
Background:
Several reports suggest that vascular endothelial growth factor (VEGF)-targeted therapy in metastatic renal cell carcinoma (mRCC) may be more toxic in Asian vs non-Asian populations. Comparative efficacy of these agents with respect to ethnicity is not well characterised.
Methods:
A multicentre, retrospective, cohort study using Asian and non-Asian centres which collected data on ethnicity, dose reductions and outcomes using the International mRCC Database Consortium.
Results:
This study included 1024 (464 Asian, 560 non-Asian) patients with a 29.4 months median follow-up. The percentage of dose modifications/reductions between non-Asians and Asians was similar (55% vs 61% P=0.1197). When adjusted for risk groups, there was no difference in overall or progression-free survival between non-Asians and Asians. Patients with dose reductions due to toxicity had longer treatment durations and overall survival than those who did not in both non-Asian (10.6 vs 5.0 months, P<0.0001; 22.6 vs 16.1 months, P=0.0016, respectively) and Asian populations (8.9 vs 5.4 months, P=0.0028; 28.0 vs 18.7 months, P=0.0069, respectively).
Conclusions:
Adjusting for risk groups, there appears to be no difference in outcome between Asian vs non-Asian patients with mRCC treated with VEGF-targeted therapy. Judicious dose reductions may allow for better outcomes in both populations due to longer treatment durations, but direct comparisons are needed.
Insights
VEGF-targeted therapy for metastatic renal cell carcinoma (mRCC) shows similar efficacy in Asian and non-Asian patients. Dose reductions due to toxicity may improve treatment duration and survival outcomes for both groups.
Area of Science:
- Oncology
- Pharmacology
Background:
- Vascular endothelial growth factor (VEGF)-targeted therapies are used for metastatic renal cell carcinoma (mRCC).
- Reports suggest potential ethnic differences in toxicity between Asian and non-Asian populations receiving VEGF-targeted therapy.
- Comparative efficacy across ethnicities is not well-characterized.
Purpose of the Study:
- To compare the efficacy and outcomes of VEGF-targeted therapy in Asian versus non-Asian patients with mRCC.
- To investigate the impact of dose modifications on treatment outcomes in different ethnic groups.
Main Methods:
- A multicentre, retrospective cohort study was conducted.
- Data were collected from Asian and non-Asian centers via the International mRCC Database Consortium.
- Ethnicity, dose reductions, and patient outcomes were analyzed.
Main Results:
- The study included 1024 patients (464 Asian, 560 non-Asian) with a median follow-up of 29.4 months.
- Dose modification rates were similar between non-Asians (55%) and Asians (61%).
- After adjusting for risk groups, no significant differences in overall survival or progression-free survival were observed between ethnic groups. Patients with dose reductions due to toxicity experienced longer treatment durations and improved overall survival in both groups.
Conclusions:
- VEGF-targeted therapy demonstrates comparable outcomes in Asian and non-Asian patients with mRCC when adjusted for risk factors.
- Judicious dose reductions, particularly due to toxicity, may enhance treatment duration and survival in both populations.
- Further direct comparative studies are warranted to confirm these findings.
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