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Handbook of Disease Burdens and Quality of Life Measures pp 2905–2922Cite as

Quality of Life in Advanced Renal Cell Carcinoma: Effect of Treatment with Cytokine Therapy and Targeted Agents

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Abstract:

Renal Cell Carcinoma (RCC) is the most common type of kidney cancer and its’ incidence is increasing steadily worldwide. Due to the asymptomatic nature of the disease it is often diagnosed in advanced stages and treatment options have been limited. Symptoms of the advanced disease along with side-effects of available treatment options can greatly affect a patients’ everyday living. The goal of therapeutic interventions in such advanced diseases is not only to increase survival but maintain or improve quality of life and functioning.

Cytokine therapy has been effective in only a select group of patients and has been associated with poor quality of life. A review of literature on quality of life in patients in advanced RCC treated with cytokine therapy revealed the use of cytokine therapy was associated with decrease in overall quality of life. Also a comparison of quality of life of patients treated with cytokine therapy with general population showed that patients treated with cytokine therapy had lower quality of life. Limited efficacy of cytokine therapies along with deterioration in QoL has led to use of these drugs in only select population.

Targeted agents such as sorafenib and sunitinib have improved efficacy. In addition these agents have an overall better QoL and improved kidney-cancer symptoms and concerns as compared to interferon. Another targeted agent temsirolimus had significantly greater quality-adjusted survival than interferon.

The current trend in the management of advanced renal cell carcinoma is the utilization of these targeted agents either alone or in combination with other agents. Targeted agents have shown efficacy and safety, and maintenance or improvement of quality of life in patients with advanced renal cell carcinoma.

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Abbreviations

CR:

complete response

EORTC-QLQ 30:

European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30

EQ-5D:

EuroQoL-5 Dimensions

FACT:

functional assessment of cancer therapy

FACT-BRM:

functional assessment of cancer therapy – biologic response modifier

FACT-G:

functional assessment of cancer therapy –, general

FKSI:

functional assessment of cancer therapy – kidney symptom index

HRQoL:

health related quality of life

IFN-α:

interferon-alpha

IL-2:

interleukin-2

mTOR:

mammalian target of rapamycin

ORR:

overall response rate

OS:

overall survival

PDGF:

platelet driven growth factor

PFS:

progression free survival

PR:

partial response

PRO:

patient reported outcomes

QoL:

quality of life

QTWiST:

quality-adjusted time without symptoms and toxicity

RCC:

renal cell carcinoma

RR:

response rate

SF-12:

Short Form-12 Health Survey

SF-36:

Short Form-36 Health Survey

TWiST:

time without symptoms and toxicity

US:

United States

VEGF:

vascular endothelial growth factor

VHL:

von Hippel-Lindau gene

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Author information

Authors and Affiliations

  1. Global Health Economics, Outcomes and Reimbursement, Bayer HealthCare Pharmaceuticals, Montville, NJ, USA

    S. Shah & K. Gondek

Authors
  1. S. Shah
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  2. K. Gondek
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Editor information

Editors and Affiliations

  1. Dept. Nutrition and Dietetics Nutritional Sciences Research Division School of Biomedical & Health Sciences, King's College London, Franklin‐Wilkins Building 150 Stamford Street, SE1 9NH, London, UK

    Victor R. Preedy (Prof.) (Prof.)

  2. Mel and Enid Zuckerman College of Public Health, University of Arizona, Health Science Center 1295 N. Martin, P.O. Box 245155, 85724-5155, Tucson, AZ

    Ronald R. Watson (Prof.) (Prof.)

Appendix

Appendix

Notes on Renal Cell Carcinoma

  • Renal Cell Carcinoma accounts for approximately 3% of adult malignancies and 90–95% of kidney cancers.

  • The causes of RCC are largely unknown. Some of the known risk factors include smoking, obesity hypertension, diabetes, occupational exposure to petroleum, asbestos and other such materials. Genetic factors have also been studies but without any conclusions.

  • RCC is often asymptomatic and rarely produces clinical signs and symptoms. Some of the signs include abdominal pain, blood in urine, fever, night sweats and weight loss. Most often it is diagnosed in advanced stages.

  • The diagnosis of RCC is done through imaging techniques such as ultrasonography and computed tomography.

  • Surgery is conducted in early stage renal cancer with curative intent.

  • In advanced stage renal cancer cytokine therapy and more recently targeted agents have been used. These drugs do not cure but prolong survival by reducing the growth of cancer cells.

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Shah, S., Gondek, K. (2010). Quality of Life in Advanced Renal Cell Carcinoma: Effect of Treatment with Cytokine Therapy and Targeted Agents. In: Preedy, V.R., Watson, R.R. (eds) Handbook of Disease Burdens and Quality of Life Measures. Springer, New York, NY. https://doi.org/10.1007/978-0-387-78665-0_169

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  • DOI: https://doi.org/10.1007/978-0-387-78665-0_169

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-78664-3

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