title: Outcome of patients with renal cell carcinoma metastatic to the brain treated with sunitinib without local therapy.
abstract: OBJECTIVE
  To assess the response of brain metastases to sunitinib in patients with renal cell carcinoma (RCC) who did not undergo prior surgical resection or radiation to the brain.
  
  
  METHODS
  We retrospectively reviewed the medical records of adult RCC patients who had metastases to the brain and received sunitinib.
  
  
  RESULTS
  Six patients with clear-cell RCC were identified between March 2006 and August 2009. All patients had ≥3 metastatic sites including the brain. Five patients received upfront sunitinib; 1 received sorafenib followed by sunitinib. Four patients had a solitary brain lesion, 1 patient had 2 lesions, and 1 patient had multiple subcentimeter lesions with the largest measuring 1.5 cm. Two patients achieved a near complete response to therapy with sunitinib and continue on treatment without recurrence in the brain for 47 and 23 months. One patient died of systemic disease without relapse in the brain. Two patients had disease progression in the brain and were salvaged with radiation therapy. One patient progressed systemically and in the brain after initial improvement in the brain.
  
  
  CONCLUSIONS
  Clear-cell RCC patients with small asymptomatic supratentorial metastases without hemorrhage or herniation safely received sunitinib as initial therapy with good response.
authors.affiliation: Department of Genitourinary Medical Oncology, M.D. Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Zita Dubauskas
authors.initials: ZD
authors.lastname: Lim
authors.forename: Anita
authors.initials: A
authors.lastname: Mahajan
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Weinberg
authors.forename: Nizar M
authors.initials: NM
authors.lastname: Tannir
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011758:Pyrroles / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077210:Sunitinib; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib