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

  • S. Shah
  • K. Gondek
Reference work entry

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.

Keywords

Vascular Endothelial Growth Factor Overall Survival Renal Cell Carcinoma Objective Response Rate Kidney Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of 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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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • S. Shah
    • 1
  • K. Gondek
    • 1
  1. 1.Global Health Economics, Outcomes and ReimbursementBayer HealthCare PharmaceuticalsMontvilleUSA

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