Sunitinib in the treatment of advanced renal cell carcinoma

Abstract

Arsenal of a modern chemotherapist exists on a wide choice of treatment of metastatic renal cell carcinoma – the discovery of immunodrugs – checkpoint inhibitors, new multikinase inhibitors and their combinations allow choosing the optimal treatment for patients of any risk group. However, the increase in the economic burden on a medical institution, which is observed every year with the emergence of more and more indications for antitumor therapy, is a limitation for the full implementation of modern immuno-targeted regimens. Therefore, it is necessary to consider the possibility of using more affordable drug options that are optimal in their antitumor response and are not significantly inferior to the newly introduced schemes. The article presents a brief overview of the mechanism of resistance of a renal cell tumor to drug exposure, describes the evolution of drug therapy for metastatic kidney cancer before the advent of sunitinib: attempts to use various cytotoxic agents, the development of immune-mediated cytokine therapy. The results of clinical trials of sunitinib in the treatment of renal cell carcinoma, comparative studies of RECORD-3 and COMPARZ, as well as private clinical cases of the use of sunitinib in real clinical practice are described. Clinical cases show the efficacy and safety of sunitinib in the presented patients – the time without progression was 30 and 26 months, and adverse events were controlled and consistent with ongoing clinical trials: patients had hematological toxicity in the form of neutropenia, anemia, arterial hypertension, dermatological toxicity in the form of discoloration hairline and palmar-plantar syndrome. All phenomena were successfully stopped, only in the case of neutropenia, the drug was postponed until the restoration of hematological parameters. It is noted that sunitinib occupies an important place in the treatment of metastatic kidney cancer at the present time.