Therapy for metastatic renal cell carcinoma should be tailored to the circumstances and preferences of the individual patient. Age should not be a barrier to effective treatment. Systematic geriatric screening and assessment contributes to the goal of personalised management, in addition to the involvement of a multidisciplinary team. A task force from the International Society of Geriatric Oncology (SIOG) updated its 2009 consensus statement on the management of elderly patients with metastatic renal cell carcinoma by reviewing data from studies involving recently approved targeted drugs and immunotherapies for this disease. Overall, it seems that age alone does not appreciably affect efficacy. Among the pivotal studies that were included, there is a striking scarcity of analyses that relate toxic effects to patient age. Even if the adverse effects of therapy are no more frequent or severe in elderly patients than in their younger counterparts, the practical, psychological, and functional impact of treatment may be greater, especially if toxic effects are chronic and cumulative.
The Lancet. Oncology. 2018 Jun 01 [Epub]
Ravindran Kanesvaran, Olivia Le Saux, Robert Motzer, Toni K Choueiri, Florian Scotté, Joaquim Bellmunt, Vincent Launay-Vacher
Division of Medical Oncology, National Cancer Centre Singapore, Singapore. Electronic address: ., Medical Oncology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France., Memorial Sloan Kettering Cancer Center, Memorial Hospital, New York, NY, USA., Dana-Farber Cancer Institute, Boston, MA, USA., Medical Oncology and Supportive Care Department, Foch Hospital, Suresnes, France., Dana-Farber Cancer Institute, Boston, MA, USA; Hospital del Mar Medical Research Institute, Parc de Salut Mar, Barcelona Spain., Service ICAR, Pitié-Salpêtrière University Hospital, Paris, France.