Contemporary trends in high-dose interleukin-2 use for metastatic renal cell carcinoma in the United States
العنوان: | Contemporary trends in high-dose interleukin-2 use for metastatic renal cell carcinoma in the United States |
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المؤلفون: | Lauren C. Harshman, Benjamin I. Chung, Parth K. Modi, Francisco Gelpi-Hammerschmidt, Toni K. Choueiri, Christopher B. Allard, Eric A. Singer, Ilker Tinay, Izak Faiena, Steven L. Chang |
المساهمون: | Allard, Christopher B., Gelpi-Hammerschmidt, Francisco, Harshman, Lauren C., Choueiri, Toni K., Faiena, Izak, Modi, Parth, Chung, Benjamin I., Tinay, Ilker, Singer, Eric A., Chang, Steven L. |
المصدر: | Urologic oncology. 33(11) |
سنة النشر: | 2015 |
مصطلحات موضوعية: | Male, medicine.medical_treatment, MELANOMA, Disease, law.invention, Cohort Studies, DOUBLE-BLIND, Therapy trends, Renal cell carcinoma, law, Neoplasm Metastasis, Kidney cancer, Middle Aged, Prognosis, CANCER, Intensive care unit, STATISTICS, Kidney Neoplasms, Oncology, Tolerability, SAFETY, Cohort, SURVIVAL, Female, Immunotherapy, Hemodialysis, medicine.medical_specialty, Urology, Antineoplastic Agents, Article, Internal medicine, medicine, Humans, Carcinoma, Renal Cell, Aged, Neoplasm Staging, Toxicity, Dose-Response Relationship, Drug, business.industry, medicine.disease, High-dose interleukin-2, United States, ANTIBODY, Immunology, Interleukin-2, INTERFERON-ALPHA, business, Follow-Up Studies |
الوصف: | Background: Targeted therapies (TTs) have revolutionized metastatic renal cell carcinoma (mRCC) treatment in the past decade, largely replacing immunotherapy including high-dose interleukin-2 (HD IL-2) therapy. We evaluated trends in HD IL-2 use for mRCC in the IT era. Methods: Our cohort comprised a weighted estimate of all patients undergoing HD IL-2 treatment for mRCC from 2004 to 2012 using the Premier Hospital Database. We assessed temporal trends in HD IL-2 use including patient. disease, and hospital characteristics stratified by era (pre-TT uptake: 2004-2006, uptake: 2007-2009, and post-TT uptake: 2010-2012) and fitted multivariable regression models to identify predictors of treatment toxicity and tolerability. Results: An estimated 2,351 patients received HD IL-2 therapy for mRCC in the United States from 2004 to 2012. The use decreased from 2004 to 2008. HD IL-2 therapy became increasingly centralized in teaching hospitals (24% of treatments in 2004 and 89.5% in 2012). Most patients who received HD IL-2 therapy were men, white, younger than 60 years, had lung metastases, and were otherwise healthy. Vasopressors, intensive care unit admission, and hemodialysis were necessary in 53.4%, 33.0%, and 7.1%, respectively. Factors associated with toxicities in multivariable analyses included being unmarried, male sex, and multiple metastatic sites. African Americans and patients with single-site metastases were less likely to receive multiple treatment cycles. Conclusions: HD IL-2 therapy is used infrequently for mRCC in the United States, and its application has diminished with the uptake of TT. Patients are being increasingly treated in teaching hospitals, suggesting a centralization of care and possible barriers to access. A recent slight increase in HD IL-2 therapy use likely reflects recognition of the inability of TT to effect a complete response. (C) 2015 Elsevier Inc. All rights reserved. |
وصف الملف: | application/pdf |
تدمد: | 1873-2496 |
الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::de577ed8edd7650b7f40d0325caf8646Test https://pubmed.ncbi.nlm.nih.gov/26210683Test |
حقوق: | OPEN |
رقم الانضمام: | edsair.doi.dedup.....de577ed8edd7650b7f40d0325caf8646 |
قاعدة البيانات: | OpenAIRE |