How do patients fare in the real world? – Clinical practice outcomes of patients treated with Pazopanib for metastatic renal cell cancer


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Victoria Galvis1, Shien Chow1, Dionne Lawrence1, Robert Hawkins1
1The Christie Hospital, Manchester, UK

Background

While there is good evidence of the efficacy and safety of Pazopanib within clinical trials, there islimited evidence of treatment outcomes among the wider population. Here we characterize and present the outcomes of Pazopanib treated patients in routine clinical practice in our centre.

Method

We identified 104 patients who commenced treatment with Pazopanib within the licensed indications from July 2006 to October 2012 with follow up toMarch 2013.Data was obtained from theChristie kidney cancer database and clinical information was obtained from the patient's records. No patient was lost to follow-up. Median OS and PFS were estimated using the Kaplan-Meier method.

Results

23% of patients were 75 years or older (range 42-87 median 66), 60% male and 29% performance status of 2 or more. A high proportion of patients had metastatic sites carrying an adverse prognosis at start of treatment (7% brain, 22% liver, and 25% bone metastases; half of these were spinal) Significant co-morbidities were frequent (13% mild, 22% moderate, 27% severe according to the ACE 27 Comorbidity Index), 69% had a Nephrectomy. 19 patients discontinued Pazopanibdue totoxicity, Liver toxicity lead to discontinuation in 7% . PFS for patients was 25, 12 and 6 m when analyzed by good, intermediate and poor prognosis by MSKCC score. It was 29, 16 and 5 when analyzed by Heng score. Median OS had not been reached in the good prognosis group by MSKCC and Heng Score.

Conclusion

The population treated reflects the nature of patients with mRCC. These poorer prognosis groups tend to be under-represented in clinical trials; often these patients are offered Pazopanib as first line treatment due to the toxicity profile reported in large trials. OS and PFS were similar to that reported in trials. Treatment was generally tolerated with rate of discontinuation due to toxicity not being different from the trial population.