Efficacy, safety, and prognostic indicators of first-line sunitinib in patients with metastatic renal cell carcinoma: A single center experience
Background: We assessed the efficacy and safety of sunitinib as the first-line treatment in metastatic renal cell carcinoma (mRCC) patients. The predictors of survival and efficacy in mRCC as identified from previous studies, including the Memorial Sloan Kettering Cancer Center (MSKCC) and the Inter...
Main Authors: | , , , , |
---|---|
Formato: | Artigo |
Publicado em: |
Medknow Publications
2018
|
Assuntos: |
_version_ | 1825721933355810816 |
---|---|
author | Ong, Teng Aik Abd Ghafar, Nahjatul Kursyiah Alip, Adlinda Yap, Ning Yi Saad, Marniza |
author_facet | Ong, Teng Aik Abd Ghafar, Nahjatul Kursyiah Alip, Adlinda Yap, Ning Yi Saad, Marniza |
author_sort | Ong, Teng Aik |
collection | UM |
description | Background: We assessed the efficacy and safety of sunitinib as the first-line treatment in metastatic renal cell carcinoma (mRCC) patients. The predictors of survival and efficacy in mRCC as identified from previous studies, including the Memorial Sloan Kettering Cancer Center (MSKCC) and the International Metastatic RCC Database Consortium (IMDC) factors, were also evaluated. Patients and Methods: Data from 56 patients with mRCC, treated with sunitinib at our institute (2006-2014), were analyzed retrospectively. Prognostic factors for overall survival (OS) and progression-free survival (PFS) were evaluated using univariate and multivariate analyses performed by log-rank test and Cox regression. Results: Fifty-one (91.1%) patients received starting dose of sunitinib of 50 mg/day in 4/2 schedule. The median PFS was 12.7 months (95% confidence interval [CI], 4.5-20.9 months) and the median OS was 16.9 months (95% CI, 3.8-29.9 months). The objective response rate was 27.5%. Dose interruption and reduction due to toxicities were required in 37.5% and 60.7% of patients, respectively. The most common Grades 3-4 toxicities were hand-foot syndrome (HFS) (23.2%), thrombocytopenia (16.1%), and hypertension (14.3%). The Eastern Cooperative Oncology Group performance status ≥2, hemoglobin < lower limit of normal, neutrophil > upper limit of normal (ULN), platelet > ULN, no prior nephrectomy, metastatic sites >1, liver metastases, lymph node metastases, and development of HFS were independent prognostic factors. Conclusions: Sunitinib treatment has acceptable efficacy and safety profile in Malaysian mRCC patients. The MSKCC and IMDC factors are relevant for predicting survival in our patient cohort while HFS is a promising prognostic predictor which warrants further investigation. |
first_indexed | 2024-03-06T05:57:54Z |
format | Article |
id | um.eprints-22757 |
institution | Universiti Malaya |
last_indexed | 2024-03-06T05:57:54Z |
publishDate | 2018 |
publisher | Medknow Publications |
record_format | dspace |
spelling | um.eprints-227572019-10-18T06:15:13Z http://eprints.um.edu.my/22757/ Efficacy, safety, and prognostic indicators of first-line sunitinib in patients with metastatic renal cell carcinoma: A single center experience Ong, Teng Aik Abd Ghafar, Nahjatul Kursyiah Alip, Adlinda Yap, Ning Yi Saad, Marniza R Medicine Background: We assessed the efficacy and safety of sunitinib as the first-line treatment in metastatic renal cell carcinoma (mRCC) patients. The predictors of survival and efficacy in mRCC as identified from previous studies, including the Memorial Sloan Kettering Cancer Center (MSKCC) and the International Metastatic RCC Database Consortium (IMDC) factors, were also evaluated. Patients and Methods: Data from 56 patients with mRCC, treated with sunitinib at our institute (2006-2014), were analyzed retrospectively. Prognostic factors for overall survival (OS) and progression-free survival (PFS) were evaluated using univariate and multivariate analyses performed by log-rank test and Cox regression. Results: Fifty-one (91.1%) patients received starting dose of sunitinib of 50 mg/day in 4/2 schedule. The median PFS was 12.7 months (95% confidence interval [CI], 4.5-20.9 months) and the median OS was 16.9 months (95% CI, 3.8-29.9 months). The objective response rate was 27.5%. Dose interruption and reduction due to toxicities were required in 37.5% and 60.7% of patients, respectively. The most common Grades 3-4 toxicities were hand-foot syndrome (HFS) (23.2%), thrombocytopenia (16.1%), and hypertension (14.3%). The Eastern Cooperative Oncology Group performance status ≥2, hemoglobin < lower limit of normal, neutrophil > upper limit of normal (ULN), platelet > ULN, no prior nephrectomy, metastatic sites >1, liver metastases, lymph node metastases, and development of HFS were independent prognostic factors. Conclusions: Sunitinib treatment has acceptable efficacy and safety profile in Malaysian mRCC patients. The MSKCC and IMDC factors are relevant for predicting survival in our patient cohort while HFS is a promising prognostic predictor which warrants further investigation. Medknow Publications 2018 Article PeerReviewed Ong, Teng Aik and Abd Ghafar, Nahjatul Kursyiah and Alip, Adlinda and Yap, Ning Yi and Saad, Marniza (2018) Efficacy, safety, and prognostic indicators of first-line sunitinib in patients with metastatic renal cell carcinoma: A single center experience. Journal of Cancer Research and Therapeutics, 14 (6). pp. 1303-1311. ISSN 0973-1482, DOI https://doi.org/10.4103/0973-1482.189247 <https://doi.org/10.4103/0973-1482.189247>. https://doi.org/10.4103/0973-1482.189247 doi:10.4103/0973-1482.189247 |
spellingShingle | R Medicine Ong, Teng Aik Abd Ghafar, Nahjatul Kursyiah Alip, Adlinda Yap, Ning Yi Saad, Marniza Efficacy, safety, and prognostic indicators of first-line sunitinib in patients with metastatic renal cell carcinoma: A single center experience |
title | Efficacy, safety, and prognostic indicators of first-line sunitinib in patients with metastatic renal cell carcinoma: A single center experience |
title_full | Efficacy, safety, and prognostic indicators of first-line sunitinib in patients with metastatic renal cell carcinoma: A single center experience |
title_fullStr | Efficacy, safety, and prognostic indicators of first-line sunitinib in patients with metastatic renal cell carcinoma: A single center experience |
title_full_unstemmed | Efficacy, safety, and prognostic indicators of first-line sunitinib in patients with metastatic renal cell carcinoma: A single center experience |
title_short | Efficacy, safety, and prognostic indicators of first-line sunitinib in patients with metastatic renal cell carcinoma: A single center experience |
title_sort | efficacy safety and prognostic indicators of first line sunitinib in patients with metastatic renal cell carcinoma a single center experience |
topic | R Medicine |
work_keys_str_mv | AT ongtengaik efficacysafetyandprognosticindicatorsoffirstlinesunitinibinpatientswithmetastaticrenalcellcarcinomaasinglecenterexperience AT abdghafarnahjatulkursyiah efficacysafetyandprognosticindicatorsoffirstlinesunitinibinpatientswithmetastaticrenalcellcarcinomaasinglecenterexperience AT alipadlinda efficacysafetyandprognosticindicatorsoffirstlinesunitinibinpatientswithmetastaticrenalcellcarcinomaasinglecenterexperience AT yapningyi efficacysafetyandprognosticindicatorsoffirstlinesunitinibinpatientswithmetastaticrenalcellcarcinomaasinglecenterexperience AT saadmarniza efficacysafetyandprognosticindicatorsoffirstlinesunitinibinpatientswithmetastaticrenalcellcarcinomaasinglecenterexperience |