Assessment of Sunitinib Alternative Prescription Schedules in Metastatic Kidney Cancer: A Study of 10 Cases.

BACKGROUND

Managing metastatic Renal Cell Carcinoma (mRCC) has been revolutionized during the first decade of the 21st century due to the development of targeted therapies. The sunitinib is an oral multi-targeted receptor Tyrosine Kinase Inhibitor (TKI). It became the first targeted therapy as first-line treatment to improve the survival of patients with metastatic kidney cancer. This treatment consists in the oral intake of 50 mg of sunitinib per day in a 6 -week cycle including 4 weeks of treatment intake (the "on" week) followed by a 2-week break (the off week). The strong impact of the treatment dose reduction or discontinuation and the associated adverse effects encouraged the investigators to enquire about other sunitinib schedules: continuous regimen at 37.5 mg of sunitinib, 2 weeks out of 3 at the dose of 50 mg. The aim of this work is to assess the efficiency and the tolerance of the other prescription regimens of sunitinib.

METHODS

This is a transversal study conducted from March 2013 until November 2017 in the Oncology/Hematology Center of the Med VI University Hospital Center in Marrakech. All patients under supervision and treatment for metastatic kidney cancer evaluated after 3, 6 and 9 months are part of our study. The parameters studies are epidemiological data, histological type, used protocols efficiency and tolerance.

RESULTS

A total of 10 patients under supervision for metastatic kidney cancer were gathered in the Oncology/Hematology Center of the Med VI University Hospital Center in Marrakech. At the end of the 9-month evaluation period, 10 patients (40%) had radiological and clinical stability, 1 patient had complete lesion response, 3 patients had radiological progression and 1 case of death was recorded. As regards toxicity, all different regimen used during the study were well tolerated by the majority of the patients. The toxicities mostly encountered were asthenia, hand-foot skin reactions, mucositis and grade II diarrhea for 4 patients (40%) and 1 case of HTA. In only one case of temporary cessation vomiting and grade II diarrhea were noted.

CONCLUSIONS

The regimen 2/1 appears to be effective and demonstrates a better toxicity profile, treatment adherence, and dose intensity in relation to treatment, suggesting that the 2/1 regimen may become the future standard sunitinib treatment for patients with mRCC.