Sunitinib Rechallenge in Patients With Metastatic Renal Cell Carcinoma |
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| Affiliation: | 1. Clinical Division of Oncology and Comprehensive Cancer Center, Department of Medicine I, Medical University of Vienna, Vienna, Austria;2. Department of Urology, Medical University of Vienna, Vienna, Austria;1. Department of Urology, Keio University School of Medicine, Tokyo, Japan;2. Genomics Unit, Keio Cancer Center, Keio University School of Medicine, Tokyo, Japan;3. Division of Diagnostic Pathology, Keio University Hospital, Tokyo, Japan;1. Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI;2. University of Michigan Rogel Cancer Center, Ann Arbor, MI;3. Department of Radiology, University of Michigan, Ann Arbor, MI;4. Department of Pathology, University of Michigan, Ann Arbor, MI;5. Department of Urology, University of Michigan, Ann Arbor, MI;1. Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy;2. Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY;3. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY;4. Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;5. Weill Cornell Medical College, Cornell University, New York, NY;6. Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy;7. Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy;8. Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy;1. Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France;2. Department of Biology, Institut Gustave Roussy, University of Paris Sud, Villejuif, France;1. Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;2. Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;3. Clinical Epidemiology and Trials Organization Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;1. Charles A. Sammons Cancer Center, Dallas, and US Oncology Research, Houston, TX;2. Urological Department, First Saint-Petersburg State Pavlov Medical University, Saint Petersburg, Russian Federation;3. Urology Department #2, Municipal Institution “Dnipropetrovsk Regional Clinical Hospital n.a. I.I. Mechnikov”, Dnipropetrovsk, Ukraine;4. Department of Oncology, Republican Clinical Oncology Dispensary, Ufa, Russian Federation;5. Lviv State Oncologic Regional Treatment and Diagnostic Center, Chemotherapy Department, Lviv, Ukraine;6. Pfizer Oncology, San Diego, CA;7. Comprehensive Cancer Centers of Nevada, Las Vegas, NV |
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| Abstract: | BackgroundSunitinib has been the standard of care for patients with metastatic renal cell carcinoma (mRCC). However, nearly all patients will eventually develop resistance. Before the introduction of novel agents, few treatment options remained after sunitinib failure. Sunitinib rechallenge is a strategy based on the presumption that resistance might be only temporary. The aim of this analysis was to evaluate the efficacy and safety of sunitinib rechallenge in patients with mRCC.Patients and MethodsPatients who had undergone sunitinib rechallenge (SU2) at the Medical University of Vienna from 2010 to 2017 were identified for the present retrospective study. The primary endpoint was the treatment duration with rechallenge (TDSU2). The secondary endpoints included the treatment duration with upfront sunitinib (TDSU1), progression-free survival (PFSSU1 and PFSSU2), overall survival (OSSU1 and OSSU2), the objective response rate in both settings (ORRSU1 and ORRSU2), and toxicity.ResultsA total of 31 patients were eligible. The median TDSU2 was 7.2 months, and the median TDSU1 was 17.8 months. The median OSSU1 and OSSU2 was 57.9 months and 14.7 months, respectively. The median PFSSU1 and PFSSU2 was 14.2 months and 5.6 months, respectively. The ORRSU1 and ORRSU2 was 34% and 16%, and another 48% and 42% achieved stable disease (SD), respectively. Fatigue and hypertension were the most common adverse events.ConclusionsSunitinib rechallenge appears to benefit patients in later treatment lines. With the abundance of novel treatment options available, this approach might appear less relevant. However, novel agents are not yet available everywhere. Thus, sunitinib rechallenge could be an additional strategy to improve the outcomes of patients with mRCC. |
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| Keywords: | mRCC Rechallenge Resistance Sunitinib Tyrosine kinase inhibitors |
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