| 1. |
- Lindskog, M, et al.
(författare)
-
Overall survival (OS) in Swedish RCC patients treated 2000-2012: Update of the RENCOMP study.
- 2015
-
Ingår i: JOURNAL OF CLINICAL ONCOLOGY. - : American Society of Clinical Oncology (ASCO). - 0732-183X .- 1527-7755. ; 33:7
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- 413 Background: The RENal COMParison (RENCOMP) study showed a significant improvement in OS for Swedish patients diagnosed with renal cell carcinoma (RCC) and metastatic (m)RCC in the first years following the introduction of targeted agents (TAs) in 2006 (Br J Cancer 2013;108:1541). Here we investigated whether a further improvement in OS can be detected in the more recent years of the TA era. Methods: Using data from the Swedish Cancer Register (diagnosis and death records), National Patient Register (in-/out-patient visit records), and Swedish Prescribed Drug Register (prescribed/dispensed drug records), we assessed OS in RCC and mRCC patients diagnosed during two periods after (2009–2012 and 2006–2008) and one period before (2000–2005 [RCC]; 2002–2005 [mRCC]) the introduction of TAs, and factors influencing OS in mRCC. Multivariate analysis was performed using a Cox proportional hazards model, including estimates of adjusted HR. The regression model included the covariates age, gender, geographical region, institution size, nephrectomy status, diagnosis period, and TA prescription. Results: In total, 3,980, 2,956, and 5,225 RCC patients were identified from 2009–2012, 2006–2008, and 2000–2005, respectively. From 2002–2012, 4,217 patients met the criteria for mRCC diagnosis. RCC patients diagnosed 2009–2012 and 2006–2008 had a significant improvement in OS compared with patients diagnosed 2000–2005 (median OS: not reached and 86 vs. 48 months, respectively; both P<0.001 [log-rank]). Likewise, mRCC patients diagnosed 2009–2012 and 2006–2008 had a significant improvement in OS compared with patients diagnosed 2002–2005 (median OS: 18.0 and 13.0 vs. 10.0 months, respectively; both P<0.001 [log rank]; with adjusted HR [95% CI] of 0.76 [0.69–0.83] and 0.97 [0.89–1.06], respectively). Factors significantly associated with longer OS in mRCC were (HR, 95% CI): female gender (0.88, 0.82–0.94), lower age (0.97, 0.97–0.98), prior nephrectomy (0.57, 0.53–0.61), and a TA prescription (0.84, 0.77–0.91). Conclusions: A continued significant improvement in OS for RCC and mRCC patients was shown, reflecting intensified medical and surgical treatment, more available TAs, and increased clinical experience.
|
|
| 2. |
- Harmenberg, U, et al.
(författare)
-
Treatment and overall survival (OS) in metastatic renal cell carcinoma (mRCC): A Swedish population-based study (2000-2008).
- 2012
-
Ingår i: JOURNAL OF CLINICAL ONCOLOGY. - : American Society of Clinical Oncology (ASCO). - 0732-183X .- 1527-7755. ; 30:5
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- 389 Background: This retrospective register study assessed OS in all mRCC patients in Sweden diagnosed before (2000–2005) and after (2006–2008) the introduction of targeted therapies, plus factors and treatment options influencing OS. Methods: Three Swedish national health registers were used: the Swedish Cancer register (diagnosis and death), the National Patient Register (in-/out-patient data), and the Swedish Prescribed Drug Register. From 2000-2008, 3,243 patients were identified with mRCC; 602 were recorded as receiving 1st-line treatment. Cox proportional hazards regression analysis, including estimation of adjusted OS, was used in three models with the covariates: diagnosis period, age, gender, institution size, nephrectomy status, geographic region (all models); mRCC treatments, defined as any tyrosine kinase inhibitor (TKI; Model 1; n=417); sunitinib (SU), sorafenib (SO), and interferon-alfa (IFN-α) in the 1st-line setting (Model 2; n=602 [SU=244, SO=110, IFN-α=248]); and variations of these drugs as 1st- and 2nd-line treatment sequences (Model 3; n=602). Results: Amongst mRCC patients diagnosed from 2006–2008 compared with 2000–2005, median adjusted OS was 16.1 vs. 10.9 months, respectively (HR=0.76, 95% CI: 0.69, 0.83; P<0.001). In all three models, factors independently associated with significantly improved OS included female gender, large institution, and prior nephrectomy. Prescription of any TKI (Model 1: HR=0.82, 95% CI: 0.73, 0.93; P=0.002) and 1st-line SU treatment (Model 2: HR=0.79, 95% CI: 0.67, 0.94; P=0.007) were associated with significantly improved OS compared with other or no treatments. A similar significant improvement in OS was also confirmed for patients treated with SU only in Model 3; however, due to a low number of observations, the model had insufficient statistical power to be appropriate for all sequences. Conclusions: An improved OS for mRCC patients was demonstrated for the period 2006-2008 compared with 2000-2005. Although the observed survival advantage is multifactorial in origin, contribution of targeted therapies is highly probable. Of the drugs studied, given design limitations, only SU was associated with improved OS.
|
|
| 3. |
|
|
| 4. |
- Lindskog, Magnus, et al.
(författare)
-
Overall survival in Swedish patients with renal cell carcinoma treated in the period 2002 to 2012: Update of the RENCOMP study with subgroup analysis of the synchronous metastatic and elderly populations
- 2017
-
Ingår i: Urologic Oncology-Seminars and Original Investigations. - : Elsevier BV. - 1078-1439 .- 1873-2496. ; 35:9, s. 541.e15-541.e22
-
Tidskriftsartikel (refereegranskat)abstract
- Background: This retrospective study investigated overall survival (OS) and factors influencing OS in Swedish patients with metastatic renal cell carcinoma (mRCC) during the pre- (2002-2005), early (2006-2008), and late (2009-2012) targeted therapy (TT) era. Methods: Three national Swedish registries identified patients with mRCC. Median OS was estimated using the Kaplan-Meier method. Multivariate analysis was performed using Cox proportional hazards regression. Subgroup analysis was conducted for patients with synchronous metastases (Ml) and the elderly (aged >= 75 y). Results: A total of 4,217 patients with mRCC were identified, including 1,533 patients with Ml and 1,275 elderly patients. For patients with mRCC diagnosed in 2002 to 2005, 2006 to 2008, and 2009 to 2012, median OS was 10.0, 13.0, and 18.0 months. Similarly, median OS improved in the M1 and elderly populations. Elderly patients were less likely to be prescribed TT (>= 75 vs. <75 y): 18.3 vs. 63.5% (in 2006-2008) and 28.6% vs. 55.9% (in 2009-2012). Diagnosis of mRCC in 2009 to 2012, nephrectomy and TT prescription were associated with improved OS in the total mRCC, Ml, and elderly populations. Conclusion: This real-world study showed continued significant improvement in mRCC OS during the late TT era, including in Ml and elderly populations. TT should be considered for all patients with mRCC based on tolerability, regardless of age. (C) 2017 Elsevier Inc. All rights reserved.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
