Sunitinib Rechallenge in Metastatic Renal Cell Carcinoma Patients
Sunitinib Rechallenge in Metastatic Renal Cell Carcinoma Patients
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DOI：
10.1002/cncr.25583
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发表时间：
2010-12-01
期刊：
影响因子：
6.2
通讯作者：
Rini, Brian I.
中科院分区：
文献类型：
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作者：
Zama, Ivan N.;Hutson, Thomas E.;Rini, Brian I.
背景：舒尼替尼是转移性肾细胞癌（mRCC）的标准初始治疗。鉴于许多患者通过多种可用疗法取得了进展，并且序贯血管内皮生长因子靶向方法已证明抗肿瘤活性，因此对舒尼替尼难治性 mRCC 中再次使用舒尼替尼的经验进行了回顾性审查。方法：回顾性鉴定先前接受舒尼替尼和其他治疗后疾病进展后接受舒尼替尼治疗的 mRCC 患者。记录患者特征、毒性、临床结果、实体瘤疗效评估标准（RECIST）客观缓解率和无进展生存期（PFS）。结果：确定了 23 名 mRCC 患者再次接受舒尼替尼治疗。再次给药后，5 名患者 (22%) 取得了客观的部分缓解。初始治疗的中位无进展生存期 (PFS) 为 13.7 个月，再次治疗时的中位无进展生存期 (PFS) 为 7.2 个月。舒尼替尼治疗间隔 > 6 个月的患者再次服用药物的 PFS 比 6 个月内开始再次服用药物的患者更长（中位 PFS，16.5 个月 vs 6.0 个月；P = .03）。根据干预治疗的数量或机制，舒尼替尼再次挑战的结果没有显着差异。在该队列的再攻击期间，没有发现大量新的毒性或先前毒性的严重程度显着增加。结论：舒尼替尼再挑战具有潜在益处，并且在某些转移性肾细胞癌患者中具有耐受性。需要进行额外的前瞻性调查。癌症 2010；116：5400-6。 (C) 2010 年美国癌症协会。
BACKGROUND: Sunitinib was a standard initial therapy in metastatic renal cell carcinoma (mRCC). Given the fact that many patients progressed through many available therapies and antitumor activity had been demonstrated with sequential vascular endothelial growth factor-targeting approaches, a retrospective review was performed of the experience of rechallenge with sunitinib in sunitinib-refractory mRCC. METHODS: mRCC patients who received sunitinib therapy after disease progression on prior sunitinib and other therapy were retrospectively identified. Patient characteristics, toxicity, clinical outcome, Response Evaluation Criteria in Solid Tumors (RECIST) objective response rate, and progression-free survival (PFS) were recorded. RESULTS: Twenty-three mRCC patients who were rechallenged with sunitinib were identified. Upon rechallenge, 5 patients (22%) achieved an objective partial response. The median PFS with initial treatment was 13.7 months and 7.2 months with rechallenge. Patients with >6-month interval between sunitinib treatments had a longer PFS with rechallenge than patients who started the rechallenge within 6 months (median PFS, 16.5 vs 6.0 months; P = .03). There was no significant difference in outcome to sunitinib rechallenge based on number or mechanism of intervening treatments. Substantial new toxicity or significantly increased severity of prior toxicity was not seen during rechallenge in this cohort. CONCLUSIONS: Sunitinib rechallenge had potential benefits and was tolerated in select metastatic RCC patients. Additional prospective investigation was warranted. Cancer 2010;116:5400-6. (C) 2010 American Cancer Society.