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.
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.
基金:
Natural Science
Foundation of China (NSFC 81402110 and 81672547),
Science and Technology Support Program of Sichuan
Province (2015SZ0230-3) and 1.3.5 project for
disciplines of excellence, West China Hospital,
Sichuan University (No.0040205301E21).
语种:
外文
PubmedID:
中科院(CAS)分区:
出版当年[2018]版:
大类|3 区医学
小类|3 区肿瘤学
最新[2023]版:
大类|3 区医学
小类|4 区肿瘤学
第一作者:
第一作者机构:[1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041
共同第一作者:
通讯作者:
通讯机构:[1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041[*1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, China,
推荐引用方式(GB/T 7714):
Zhang Xingming,Sun Guangxi,Zhao Jinge,et al.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].Journal of Cancer.2018,9(18):3303-3310.doi:10.7150/jca.25693.
APA:
Zhang Xingming,Sun Guangxi,Zhao Jinge,Shu Kunpeng,Zhao Peng...&Zeng Hao.(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)
MLA:
Zhang Xingming,et al."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(2018):3303-3310