J Cancer
2018; 9(18):3303-3310.
doi:10.7150/jca.25693 This issueCite
Research Paper
Improved Long-Term Clinical Outcomes And Safety Profile Of Sunitinib Dosing Schedule With 4/2 Switched To 2/1 In Patients With Metastatic Renal Cell Carcinoma
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041 *These three authors are co-first authors of the manuscript
✉ Corresponding authors: Jia Wang and Hao Zeng. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, China, 610041; Tel.: +86 18980602129; E-mail: cdhx510com(Hao zeng); Fax: +86 2885422451.More
Citation:
Zhang X, Sun G, Zhao J, Shu K, Zhao P, Liu J, Yang Y, Tang Q, Chen J, Shen P, Wang J, Zeng H. Improved Long-Term Clinical Outcomes And Safety Profile Of Sunitinib Dosing Schedule With 4/2 Switched To 2/1 In Patients With Metastatic Renal Cell Carcinoma. J Cancer 2018; 9(18):3303-3310. doi:10.7150/jca.25693. https://www.jcancer.org/v09p3303.htm
Purpose: This study aimed to identify the survival benefit and safety of alternative dosage schedules for sunitinib in metastatic renal cell carcinoma.
Materials and Methods: Clinicopathologic and survival data of patients treated with sunitinib as first-line therapy were retrospectively reviewed. Patients were classified into three groups: a standard dosing schedule (4/2 schedule), alternative dosing schedule (2/1 schedule), and switched dosing schedule (4/2-2/1 schedule).
Results: Ninety-nine patients were retrospectively included. Seventy-five (75.8%) patients were initially administrated with a 4/2 schedule of sunitinib, while 24 were started with the 2/1 schedule. During treatment, 45 (60.0%) patients with an initial 4/2 schedule switched to a 2/1 schedule (4/2-2/1 schedule) due to severe adverse events (AEs) or poor tolerance. Compared to that with a 4/2 schedule, patients with a 2/1 schedule had a much lower incidence of grade 3/4 AEs (69.6% vs. 40.6%, p=0.001). Overall, the 4/2-2/1 schedule was associated with the best survival benefits. Among the 4/2, 2/1, and 4/2-2/1 schedule groups, the median PFS was 12.5, 11.0, and 25.0 months, respectively (p=0.003), and the median OS was 21.0, 28.0, and 52.0 months, respectively (p=0.03). Multivariate analysis identified the 4/2-2/1 schedule as an independent factor predicting favorable PFS. Although without statistical significance, 4/2-2/1 schedule could decrease 55% risk of death. Furthermore, patients with unfavorable IMDC risk seemed to have more opportunity to achieve better survival from the 4/2-2/1 dosing schedule.
Conclusion: Patients with a 4/2-2/1 schedule could minimize treatment-related toxicities; more importantly, patients with 4/2-2/1 schedule could achieve a superior survival benefit.
Zhang, X., Sun, G., Zhao, J., Shu, K., Zhao, P., Liu, J., Yang, Y., Tang, Q., Chen, J., Shen, P., Wang, J., Zeng, H. (2018). Improved Long-Term Clinical Outcomes And Safety Profile Of Sunitinib Dosing Schedule With 4/2 Switched To 2/1 In Patients With Metastatic Renal Cell Carcinoma. Journal of Cancer, 9(18), 3303-3310. https://doi.org/10.7150/jca.25693.
ACS
Zhang, X.; Sun, G.; Zhao, J.; Shu, K.; Zhao, P.; Liu, J.; Yang, Y.; Tang, Q.; Chen, J.; Shen, P.; Wang, J.; Zeng, H. Improved Long-Term Clinical Outcomes And Safety Profile Of Sunitinib Dosing Schedule With 4/2 Switched To 2/1 In Patients With Metastatic Renal Cell Carcinoma. J. Cancer 2018, 9 (18), 3303-3310. DOI: 10.7150/jca.25693.
NLM
Zhang X, Sun G, Zhao J, Shu K, Zhao P, Liu J, Yang Y, Tang Q, Chen J, Shen P, Wang J, Zeng H. Improved Long-Term Clinical Outcomes And Safety Profile Of Sunitinib Dosing Schedule With 4/2 Switched To 2/1 In Patients With Metastatic Renal Cell Carcinoma. J Cancer 2018; 9(18):3303-3310. doi:10.7150/jca.25693. https://www.jcancer.org/v09p3303.htm
CSE
Zhang X, Sun G, Zhao J, Shu K, Zhao P, Liu J, Yang Y, Tang Q, Chen J, Shen P, Wang J, Zeng H. 2018. Improved Long-Term Clinical Outcomes And Safety Profile Of Sunitinib Dosing Schedule With 4/2 Switched To 2/1 In Patients With Metastatic Renal Cell Carcinoma. J Cancer. 9(18):3303-3310.
This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.