Efficacy evaluation of sunitinib in the individualized treatment of metastatic renal cell carcinoma

Abstract

Objective To evaluate the efficacy and safety of sunitinib in the individualized treatment of metastatic clear cell and papillary renal cell carcinoma.Methods The data of 44 patients (33 cases of metastatic renal clear cell carcinoma (mRCC) and 11 cases of metastatic papillary renal cell carcinoma) were analyzed retrospectively in West China Hospital from Apr.2008 to Sept.2012.Progression free survival (PFS),overall survival (OS) and adverse events were compared,and SPSS17.0 software was used to evaluate the effect,adverse events and the risk factors.Results The median sunitinib therapeutic cycle was 19.1 and the median follow-up time was 30 months.Among the 44 patients,18 patients were treated with standard therapeutic schedule,while 26 patients were treated with adjusted alternative schedule.The median PFS,OS,tumor objective response rate and disease control rate for the entire cohort were 14 months,37 months,34％ (15/44) and 71％ (31/44),respectively.Survival analysis demonstrated that neither histological types nor individual therapeutic regimen was associated with efficacy of sunitinib.Multivariate analysis demonstrated that solitary lung or lymph node metastasis was the only independent factor predicting the effectiveness of sunitinib in the treatment of mRCC.Although incidence of hypertension,hand-foot syndrome and oral mucositis was relatively high,all adverse events were tolerable and reversible.Compared to patients with standard schedule,the proptrtion of dose reduction or interruption was much lower in patients with alternative schedule (35％ vs.67％,P=0.034).Conclusion Sunitinib may have similar effect on metastatic renal clear cell carcinoma and papillary renal cell carcinoma,and the individualized therapeutic schedules of sunitinib maximize the efficacy and safety of sunitinib. Key words: Sunitinib; Metastatic renal cell carcinoma; Individualized treatment; Efficacy