Response of renal lesions during systemic treatment with sunitinib in patients with metastatic renal cell carcinoma

TY - JOUR

T1 - Response of renal lesions during systemic treatment with sunitinib in patients with metastatic renal cell carcinoma

T2 - a single center experience with 14 patients

AU - Seidel, C

AU - Fenner, M

AU - Merseburger, A S

AU - Reuter, C

AU - Ivanyi, P

AU - Länger, F

AU - Ganser, A

AU - Grünwald, V

PY - 2011/6

Y1 - 2011/6

N2 - PURPOSE: The tyrosine kinase inhibitor (TKI) sunitinib induces partial remissions (PR) in a substantial proportion of patients with metastatic renal cell carcinoma (mRCC). Only little is known about the activity of sunitinib in renal lesions in patients with metastatic disease, as most patients with synchronous metastases receive palliative nephrectomy.METHODS: Fourteen patients with clear cell mRCC with renal lesions and sunitinib therapy (50 mg OD, 4/2 scheme) were retrieved retrospectively from clinic records. Tumor assessment consisted of CT scans at least every two cycles, analyzed according to RECIST. In 5 of 14 patients, renal tumors were considered as the primary tumor, while the remaining patients had kidney metastases. In total, 65 target lesions were evaluated.RESULTS: The median progression-free survival (PFS) of sunitinib was 8.7 months (range: 2.7-40.2). Median overall survival (OS) from initiation of TKI therapy was 26 months (range: 3-55). Best response according to RECIST consisted of partial remission (PR) in 4 patients, stable disease (SD) in 7 patients, a complete remission (CR) in 1 patient, and 2 patients with progressive disease (PD). Analyzing the response of renal lesions only, 1 patient had PD, 8 patients had SD, 4 patients had PR, and 1 had a CR. Palliative nephrectomy was performed after two courses of sunitinib in 2 patients.CONCLUSIONS: In our cohort, similar responses of renal tumors and peripheral metastases were achieved with sunitinib treatment. Our results support the use of sunitinib to control renal tumor lesions in metastatic patients.

AB - PURPOSE: The tyrosine kinase inhibitor (TKI) sunitinib induces partial remissions (PR) in a substantial proportion of patients with metastatic renal cell carcinoma (mRCC). Only little is known about the activity of sunitinib in renal lesions in patients with metastatic disease, as most patients with synchronous metastases receive palliative nephrectomy.METHODS: Fourteen patients with clear cell mRCC with renal lesions and sunitinib therapy (50 mg OD, 4/2 scheme) were retrieved retrospectively from clinic records. Tumor assessment consisted of CT scans at least every two cycles, analyzed according to RECIST. In 5 of 14 patients, renal tumors were considered as the primary tumor, while the remaining patients had kidney metastases. In total, 65 target lesions were evaluated.RESULTS: The median progression-free survival (PFS) of sunitinib was 8.7 months (range: 2.7-40.2). Median overall survival (OS) from initiation of TKI therapy was 26 months (range: 3-55). Best response according to RECIST consisted of partial remission (PR) in 4 patients, stable disease (SD) in 7 patients, a complete remission (CR) in 1 patient, and 2 patients with progressive disease (PD). Analyzing the response of renal lesions only, 1 patient had PD, 8 patients had SD, 4 patients had PR, and 1 had a CR. Palliative nephrectomy was performed after two courses of sunitinib in 2 patients.CONCLUSIONS: In our cohort, similar responses of renal tumors and peripheral metastases were achieved with sunitinib treatment. Our results support the use of sunitinib to control renal tumor lesions in metastatic patients.

KW - Adult

KW - Aged

KW - Antineoplastic Agents

KW - Carcinoma, Renal Cell

KW - Disease Progression

KW - Dose-Response Relationship, Drug

KW - Female

KW - Humans

KW - Indoles

KW - Kidney

KW - Kidney Neoplasms

KW - Male

KW - Middle Aged

KW - Nephrectomy

KW - Palliative Care

KW - Protein-Tyrosine Kinases

KW - Pyrroles

KW - Retrospective Studies

KW - Treatment Outcome

U2 - 10.1007/s00345-010-0642-3

DO - 10.1007/s00345-010-0642-3

M3 - SCORING: Journal article

C2 - 21258806

VL - 29

SP - 355

EP - 360

JO - WORLD J UROL

JF - WORLD J UROL

SN - 0724-4983

IS - 3

ER -