Anti-VEGF therapy in mRCC: differences between Asian and non-Asian patients

Wang, YChoueiri, T KLee, J-LTan, M-HRha, S YNorth, S AKollmannsberger, C KMcDermott, D FHeng, D Y C2015-04-012014Wang, Y, T K Choueiri, J-L Lee, M-H Tan, S Y Rha, S A North, C K Kollmannsberger, D F McDermott, and D Y C Heng. 2014. “Anti-VEGF therapy in mRCC: differences between Asian and non-Asian patients.” British Journal of Cancer 110 (6): 1433-1437. doi:10.1038/bjc.2014.28. http://dx.doi.org/10.1038/bjc.2014.28.0007-0920http://nrs.harvard.edu/urn-3:HUL.InstRepos:14351289Background: 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.en-USsunitinibsorafenibethnicityVEGFprogression-free survivaloverall survivalAnti-VEGF therapy in mRCC: differences between Asian and non-Asian patientsJournal Article2015-04-0110.1038/bjc.2014.28