Efficacy and safety of perioperative appliance of sunitinib in patients with metastatic or advanced renal cell carcinoma: A systematic review and meta-analysis.

Abstract

Background:The aim of this systematic review and meta-analysis is to comprehensively evaluate the efficacy and safety of the perioperative use of sunitinib in patients with metastatic and advanced renal cell carcinoma (RCC).Materials and methods:We searched authenticated databases for related clinical studies. The baseline characteristics, parameters concerning the efficacy and safety of the perioperative use of sunitinib were extracted for subsequent comprehensive analysis. The parameters which reflected the efficacy and safety as overall survival (OS), progression-free survival (PFS), occurrence rate of all-grade and grade ≥3 adverse effects (AEs) were carefully pooled using comprehensive meta-analysis.Results:We finally recruited 411 patients from 14 eligible studies. We found proteinuria (75.0%, 95% CI 62.1%–84.6%), anemia (71.6%, 95% CI 60.9%–80.3%), athesia (60.0%, 95% CI 40.3%–77.0%), pause symptoms (59.2%, 95% CI 49.2%–68.4%), arterial hypertension (53.1%, 95% CI 43.2%–62.7%), and thrombocytopenia (52.5%, 95% CI 44.8%–60.0%) to be the most common all-grade AEs. And arterial hypertension, athesia, cutaneous toxicity, hypophosphatemia, leukopenia, pain, pause syndrome, renal dysfunction, and thrombocytopenia were the most common types of grade ≥3 AEs. In addition, objective response rate (ORR) of sunitinib to both the original and metastatic tumor sites increased with the use of sunitinib, so did the OS and PFS.Conclusion:Common all-grade and grade ≥3 AEs were carefully monitored. The perioperative use of sunitinib showed superior ORR, OS, and PFS rates. Nevertheless, more studies are required to further verify these findings.