title: Alternative dosing schedules for sunitinib as a treatment of patients with metastatic renal cell carcinoma.
abstract: Sunitinib malate (Sutent; Pfizer, Inc., New York, NY) is an oral multitargeted tyrosine kinase inhibitor that inhibits VEGF receptors (VEGFR-1, VEGFR-2, and VEGFR-3) among a family of kinase targets and have a central role in first-line treatment of metastatic renal cell carcinoma (mRCC). The approved schedule for sunitinib is 50mg/day oid in the so called "4 weeks on and two weeks off" (4/2 schedule). Since treatment with sunitinib can be maintained for years, adequate treatment of adverse events (AEs) and care for quality of life is essential. For this reason, several alternative schedules have been proposed in order to personalize sunitinib administration and reduce related toxicity. This review discusses the efficacy and tolerability of alternative regimens to the standard 4/2 schedule that have been investigated in RCC patients including schedule of 50mg/day 2-weeks on/1-week off, continuous schedule of 37.5mg daily and the "Stop and Go strategy".
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Fancesco Maria
authors.initials: FM
authors.lastname: Guida
authors.affiliation: Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, via Conca 71, 60126 Ancona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.affiliation: Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, via Conca 71, 60126 Ancona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Conti
authors.affiliation: Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, via Conca 71, 60126 Ancona, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Burattini
authors.affiliation: Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, via Conca 71, 60126 Ancona, Italy.
authors.forename: Agnese
authors.initials: A
authors.lastname: Savini
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Tea
authors.initials: T
authors.lastname: Zeppola
authors.affiliation: Department of General Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Caricato
authors.affiliation: Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, via Conca 71, 60126 Ancona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tonini
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy. Electronic address: d.santini@unicampus.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology*; D004334:Drug Administration Schedule; D006801:Humans; D007211:Indoles / Q000008:administration & dosage*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D009362:Neoplasm Metastasis; D011758:Pyrroles / Q000008:administration & dosage*; D000077210:Sunitinib; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib
keywords: Alternative schedule; Metastatic renal cell carcinoma; Sunitinib; Two weeks on/one week off.