Management of sunitinib-related adverse events: an evidence- and expert-based consensus approach.
BACKGROUND
The advance of medical treatment in renal cell carcinoma (RCC) has fostered the development of diverse continuous oral therapies with tyrosine kinase inhibitors (TKI), among these sunitinib remains the mainstay of therapy for most of the patients. Based on its clinical activity, disease control over a period of 11 months can be expected with sunitinib treatment. Given this prolonged period of exposure to sunitinib, adverse events tend to reoccur and can possibly decrease the quality of life in our patients. Hence, development of modalities to detect, treat and cope with such adverse events has become a major focus for physicians and patients. Today, numerous publications address these questions and offer advice from experienced centers. However, these reviews summarize single or oligo-center experiences.


RESULTS
Our approach is based (1) on an extensive review and analysis of available evidence from literature and (2) a structured consensus survey among 12 German experts in the field who treated at least 30 patients each with a TKI.


CONCLUSIONS
Derived from this process, this paper gives an overview on Sunitinib therapy management recommendations deducted from published evidence and consensus agreement among experts.
Grünwald
Viktor
V
Clinic for Hematology, Hemostaseology, Oncology and Stem Cell Transplantation, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
Kalanovic
Daniel
D
Merseburger
Axel S
AS
D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000188:drug therapy*; D032921:Consensus; D003967:Diarrhea / Q000139:chemically induced / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D055088:Early Detection of Cancer; D019317:Evidence-Based Medicine; D005221:Fatigue / Q000139:chemically induced / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000188:drug therapy; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects*; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D009059:Mouth Diseases / Q000139:chemically induced / Q000628:therapy; D017410:Practice Guidelines as Topic; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects*; D018570:Risk Assessment; D012871:Skin Diseases / Q000139:chemically induced / Q000188:drug therapy; D000077210:Sunitinib; D016896:Treatment Outcome
D007211:Indoles; D047428:Protein Kinase Inhibitors; D011758:Pyrroles; D000077210:Sunitinib
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