Abstract
Background
The aim was to assess the relationship between treatment efficacy and adverse events
(AEs) for patients with advanced renal cell carcinoma treated with first-line sunitinib.
Patients and Methods
274 patients were treated with sunitinib (50 mg/d, 4-weeks-on and 2-weeks-off schedule).
Physical and laboratory evaluations were done every sixth week. AEs were diagnosed
at every visit. Clinical response was assessed every 3 months. The objective response
rate (ORR), median progression-free (mPFS) and median overall survival (mOS) and AEs
were evaluated. Besides χ2 and log rank tests, multivariate Cox regression analysis and for synergism 1-sided
t tests were used.
Results
The ORR was 25%. After a median follow-up of 32 months, the mPFS and mOS were 9 and
19 months, respectively. Hypertension, diarrhea, hypothyroidism, mucositis, hand-foot
syndrome (HFS), skin toxicity, and leukopenia were the most frequent treatment-associated
AEs. Significantly longer (P < .01) mPFS and mOS were observed when hypertension, diarrhea, HFS, hypothyroidism,
skin toxicity, or leukopenia occurred. A statistically significant synergistic effect
of the listed AEs was observed for progression-free survival (P < .001) and overall survival (P < .001). Multivariate analysis revealed that besides the prognostic category, the
higher number of AEs (3-6 vs. 0-2) was an independent marker of longer mPFS (24 vs.
5 months, respectively; P < .001) and mOS (51 vs. 9 months, respectively; P < .001).
Conclusion
Results of this study provide evidence for the synergistically enhanced efficacy of
sunitinib treatment in patients who present multiple AEs. These AEs are diagnosed
routinely and their coexistence can help physicians to predict which group of patients
would benefit the most from first-line sunitinib treatment.
Keywords
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Article info
Publication history
Published online: December 07, 2015
Accepted:
November 30,
2015
Received:
September 30,
2015
Identification
Copyright
© 2015 Elsevier Inc. All rights reserved.
