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Research paper (original)
Published online: 2024-04-19
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Outcomes of treatment, laboratory results, adverse effects, and tolerability of cancer treatment in patients with metastatic renal cell carcinoma treated with sunitinib after cytoreductive nephrectomy

Maciej Michalak1, Piotr Tomczak2, Tomasz Milecki1, Andrzej Antczak1
Affiliations
  1. Department and Clinic of Urology and Oncological Urology, Poznan University of Medical Sciences, Poznan, Poland
  2. Department of Oncology, Poznan University of Medical Sciences, Poznan, Poland

open access

Ahead of print
Original articles – Tumor biology
Published online: 2024-04-19

Abstract

Introduction. This publication aims to present the results of a retrospective analysis of the treatment outcomes of patients with metastatic renal cell carcinoma (RCC) who underwent cytoreductive nephrectomy (CN) followed by systemic treatment with sunitinib.

Material and methods. The retrospective analysis includes the results of 67 patients treated and followed up at the Institute of Oncology of the Poznan University of Medical Sciences.

Results. Among the 67 patients included in the study, 24 were female (35.82%) and 43 were male (64.18%). The patients treated with sunitinib experienced several adverse effects, including weight loss, anaemia, neutropenia, hypokalemia, and thyroid dysfunction. For these reasons, some patients (n = 32, 47.76%) required a reduction in the dose of sunitinib. The most common reason for sunitinib discontinuation was disease progression (n = 52, 77.61%).

Conclusions. Treatment with sunitinib requires regular clinical and laboratory monitoring to appropriately reduce the drug dose or increase the interval between drug cycles in the event of adverse effects.

Abstract

Introduction. This publication aims to present the results of a retrospective analysis of the treatment outcomes of patients with metastatic renal cell carcinoma (RCC) who underwent cytoreductive nephrectomy (CN) followed by systemic treatment with sunitinib.

Material and methods. The retrospective analysis includes the results of 67 patients treated and followed up at the Institute of Oncology of the Poznan University of Medical Sciences.

Results. Among the 67 patients included in the study, 24 were female (35.82%) and 43 were male (64.18%). The patients treated with sunitinib experienced several adverse effects, including weight loss, anaemia, neutropenia, hypokalemia, and thyroid dysfunction. For these reasons, some patients (n = 32, 47.76%) required a reduction in the dose of sunitinib. The most common reason for sunitinib discontinuation was disease progression (n = 52, 77.61%).

Conclusions. Treatment with sunitinib requires regular clinical and laboratory monitoring to appropriately reduce the drug dose or increase the interval between drug cycles in the event of adverse effects.

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Keywords

sunitinib; metastatic renal cell carcinoma; cytoreductive nephrectomy; CARMENA; SURTIME

About this article
Title

Outcomes of treatment, laboratory results, adverse effects, and tolerability of cancer treatment in patients with metastatic renal cell carcinoma treated with sunitinib after cytoreductive nephrectomy

Journal

Nowotwory. Journal of Oncology

Issue

Ahead of print

Article type

Research paper (original)

Published online

2024-04-19

Page views

33

Article views/downloads

18

DOI

10.5603/njo.98971

Keywords

sunitinib
metastatic renal cell carcinoma
cytoreductive nephrectomy
CARMENA
SURTIME

Authors

Maciej Michalak
Piotr Tomczak
Tomasz Milecki
Andrzej Antczak

References (28)
  1. Osawa T, Takeuchi A, Kojima T, et al. Overview of current and future systemic therapy for metastatic renal cell carcinoma. Jpn J Clin Oncol. 2019; 49(5): 395–403.
  2. Choueiri TK, Motzer RJ. Systemic Therapy for Metastatic Renal-Cell Carcinoma. N Engl J Med. 2017; 376(4): 354–366.
  3. Motzer RJ, Hutson TE, Tomczak P, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007; 356(2): 115–124.
  4. Motzer RJ, Hutson TE, Tomczak P, et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009; 27(22): 3584–3590.
  5. Motzer RJ, Escudier B, Gannon A, et al. Sunitinib: Ten Years of Successful Clinical Use and Study in Advanced Renal Cell Carcinoma. Oncologist. 2017; 22(1): 41–52.
  6. Ferrari SM, Centanni M, Virili C, et al. Sunitinib in the Treatment of Thyroid Cancer. Curr Med Chem. 2019; 26(6): 963–972.
  7. Touyz RM, Herrmann J. Cardiotoxicity with vascular endothelial growth factor inhibitor therapy. NPJ Precis Oncol. 2018; 2: 13.
  8. Cohen R, Bihan H, Uzzan B, et al. [Sunitinib and hypothyroidism]. Ann Endocrinol (Paris). 2007; 68(5): 332–336.
  9. Fallahi P, Ferrari SM, Vita R, et al. Thyroid dysfunctions induced by tyrosine kinase inhibitors. Expert Opin Drug Saf. 2014; 13(6): 723–733.
  10. Méjean A, Ravaud A, Thezenas S, et al. Sunitinib Alone or after Nephrectomy in Metastatic Renal-Cell Carcinoma. N Engl J Med. 2018; 379(5): 417–427.
  11. Bex A, Mulders P, Jewett M, et al. Comparison of Immediate vs Deferred Cytoreductive Nephrectomy in Patients With Synchronous Metastatic Renal Cell Carcinoma Receiving Sunitinib: The SURTIME Randomized Clinical Trial. JAMA Oncol. 2019; 5(2): 164–170.
  12. Powles T, Kayani I, Blank C, et al. The safety and efficacy of sunitinib before planned nephrectomy in metastatic clear cell renal cancer. Ann Oncol. 2011; 22(5): 1041–1047.
  13. Powles T, Blank C, Chowdhury S, et al. The outcome of patients treated with sunitinib prior to planned nephrectomy in metastatic clear cell renal cancer. Eur Urol. 2011; 60(3): 448–454.
  14. Shuch B, Riggs SB, LaRochelle JC, et al. Neoadjuvant targeted therapy and advanced kidney cancer: observations and implications for a new treatment paradigm. BJU Int. 2008; 102(6): 692–696.
  15. Patard JJ, Thuret R, Raffi A, et al. Treatment with sunitinib enabled complete resection of massive lymphadenopathy not previously amenable to excision in a patient with renal cell carcinoma. Eur Urol. 2009; 55(1): 237–9; quiz 239.
  16. Jebreel A, England J, Bedford K, et al. Vascular endothelial growth factor (VEGF), VEGF receptors expression and microvascular density in benign and malignant thyroid diseases. Int J Exp Pathol. 2007; 88(4): 271–277.
  17. Yamada E, Yamazaki K, Takano K, et al. Iodide inhibits vascular endothelial growth factor-A expression in cultured human thyroid follicles: a microarray search for effects of thyrotropin and iodide on angiogenesis factors. Thyroid. 2006; 16(6): 545–554.
  18. Mannavola D, Coco P, Vannucchi G, et al. A novel tyrosine-kinase selective inhibitor, sunitinib, induces transient hypothyroidism by blocking iodine uptake. J Clin Endocrinol Metab. 2007; 92(9): 3531–3534.
  19. Desai J, Yassa L, Marqusee E, et al. Hypothyroidism after sunitinib treatment for patients with gastrointestinal stromal tumors. Ann Intern Med. 2006; 145(9): 660–664.
  20. Wong E, Rosen LS, Mulay M, et al. Sunitinib induces hypothyroidism in advanced cancer patients and may inhibit thyroid peroxidase activity. Thyroid. 2007; 17(4): 351–355.
  21. Makita N, Miyakawa M, Fujita T, et al. Sunitinib induces hypothyroidism with a markedly reduced vascularity. Thyroid. 2010; 20(3): 323–326.
  22. Motzer RJ, Rini BI, McDermott DF, et al. CheckMate 214 investigators. Nivolumab plus ipilimumab versus sunitinib in first-line treatment for advanced renal cell carcinoma: extended follow-up of efficacy and safety results from a randomised, controlled, phase 3 trial. Lancet Oncol. 2019; 20(10): 1370–1385.
  23. Cella D, Grünwald V, Escudier B, et al. Patient-reported outcomes of patients with advanced renal cell carcinoma treated with nivolumab plus ipilimumab versus sunitinib (CheckMate 214): a randomised, phase 3 trial. Lancet Oncol. 2019; 20(2): 297–310.
  24. Motzer RJ, Hutson TE, Cella D, et al. Pazopanib versus sunitinib in metastatic renal-cell carcinoma. N Engl J Med. 2013; 369(8): 722–731.
  25. Choueiri T, Hessel C, Halabi S, et al. Cabozantinib versus sunitinib as initial therapy for metastatic renal cell carcinoma of intermediate or poor risk (Alliance A031203 CABOSUN randomised trial): Progression-free survival by independent review and overall survival update. European Journal of Cancer. 2018; 94: 115–125.
  26. Wysocki P, Chłosta P, Chrzan R, et al. Zalecenia postępowania diagnostyczno-terapeutycznego w raku nerkowokomórkowym — aktualizacja. Onkol Prakt Klin Edu. 2022; 8(6): 424–457.
  27. Wojciechowska U, Barańska K, Miklewska M, et al. Cancer incidence and mortality in Poland in 2020. Nowotwory. Journal of Oncology. 2023; 73(3): 129–145.
  28. Krawczyk P. Only one step from tailored oncological therapies. Nowotwory. Journal of Oncology. 2018; 68(1): 42–45.

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