Cabozantinib use in metastatic renal cell carcinoma patients in clinical practice: Evaluation of dosing patterns, tolerability, and outcomes compared to clinical trials
| Autor: | Jennifer Mikoll, Amy Sion, Erin R. Weeda, Jessica H McElwee, Theodore Stewart Gourdin |
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| Rok vydání: | 2019 |
| Předmět: |
Male
0301 basic medicine Oncology medicine.medical_specialty Cabozantinib Pyridines medicine.drug_class Tyrosine-kinase inhibitor 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Renal cell carcinoma Internal medicine medicine Humans Anilides Pharmacology (medical) Dosing Carcinoma Renal Cell Protein Kinase Inhibitors Aged Retrospective Studies Clinical Trials as Topic business.industry Middle Aged medicine.disease Dose intensity Kidney Neoplasms Clinical trial Clinical Practice 030104 developmental biology Tolerability chemistry 030220 oncology & carcinogenesis Female business |
| Zdroj: | Journal of Oncology Pharmacy Practice. 26:861-865 |
| ISSN: | 1477-092X 1078-1552 |
| DOI: | 10.1177/1078155219875509 |
| Popis: | IntroductionDespite first-line approval in metastatic renal cell carcinoma (mRCC), the tyrosine kinase inhibitor cabozantinib is associated with frequent treatment-limiting side effects. Dose reductions in published trials of the drug and in clinical practice are commonplace. We analyzed our institution’s real-world experience with cabozantinib dosing in patients with mRCC to assess strategies to improve tolerability and patient outcomes.ObjectivesThe purpose of our study is to retrospectively analyze dose intensity, tolerability, and duration of exposure in mRCC patients who received cabozantinib at our institution.MethodsIn this retrospective, single-center chart review, we identified 35 adult patients who received at least one cycle cabozantinib for mRCC during a two-year period. Dosing patterns were reviewed for each patient to allow calculation of median dose intensity and median duration of exposure.ResultsThe median dose intensity for cabozantinib was 55.4% and the median actual daily dose was 33.2 mg. Median duration of cabozantinib exposure was 10.4 months. Several alternative dosing strategies were employed with 60% of patients requiring at least one dose intervention to manage toxicities.ConclusionsPatients in this analysis received a median actual daily dose of 33.4 mg, less than the reported median doses in the METEOR and CABOSUN trials. However, our median duration of cabozantinib treatment was 10.4 months compared to 8.3 months and 6.5 months in these respective trials. Further investigation is warranted to determine if alternative dosing strategies and lower median actual daily doses produce survival results comparable to published clinical trials. |
| Databáze: | OpenAIRE |
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