Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian national cancer institute (Inca) experience

Vol. 42 (4): 694-703, July – August, 2016

doi: 10.1590/S1677-5538.IBJU.2015.0226


ORIGINAL ARTICLE

Rafael Corrêa Coelho 1, Tomás Reinert 1, Franz Campos 2, Fábio Affonso Peixoto 1, Carlos Augusto de Andrade 1, Thalita Castro 3, Daniel Herchenhorn 1

1 Departamento de Clínica Oncologia, Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA), SP, Brasil; 2 Departamento de Urologia – Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA), SP, Brasil; 3 Departamento de Estatística – Centro de Pesquisa Clínica (CPQ) – Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA), SP, Brasil

ABSTRACT

Purpose: The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC) treated by the Brazilian Unified Health System (SUS) at a single reference institution.
Material and Methods: Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013.
Results: Fifty-eight patients were eligible. Most patients were male 41 (71%), with a median age of 58 years. Nephrectomy was performed in 41 (71%) patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2%) patients. In 50 patients (86%), sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%), hypothyroidism (43%), mucositis (33%) and diarrhea (29%). Grade 3 and 4 adverse effects were infrequent: fatigue (12%), hypertension (12%), thrombocytopenia (7%), neutropenia (5%) and hand-foot syndrome (5%). Forty-three percent of patients achieved a partial response and 34% stable disease, with a disease control rate of 77%. Median progression free survival was 7.6 months and median overall survival was 14.1 months.
Conclusion: Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS.

Keywords: Neoplasm Metastasis; Kidney Neoplasms; sunitinib [Supplementary Concept]; Retrospective Studies

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