title: [Therapeutic significance of sunitinib-induced "off-target" side effects].
abstract: Sunitinib is a basic medicine in the therapy of metastatic clear cell renal carcinoma. Our aim was to retrospectively evaluate the efficacy of sunitinib in the everyday clinical practice taking the most common side effects and clinical features into consideration. Data of ninety-four patients with metastatic, clear cell renal carcinoma, receiving sunitinib therapy were analyzed retrospectively, regarding efficacy and toxicity. Factors potentially influencing progression-free survival (PFS) and overall survival (OS) [age, nephrectomy, "off-target" side effects that are not connected to vascular endothelial growth factor receptor (VEGFR)] were studied. Complete remission, partial remission and stable disease occurred in 8 (8.5%), 30 (31.9%) and 50 (53.1%) patients, respectively. Objective tumor response developed in 38 (40.4%) cases. Median PFS and OS were 18.3 (95% CI 14.45-22.14) and 27.9 (95% CI 20.95-34.85) months, respectively. PFS and OS were more favorable in case of hypothyreosis (pPFS=0.005, pOS=0.043), hand-foot syndrome (pPFS=0.006, pOS=0.008), grade ≥2 neutropenia (pPFS=0.003, pOS=0.008) and thrombocytopenia (pPFS=0.01, pOS=0.011). Effective therapy of manageable side effects (most of which have potential predictive effect) is important for favorable survival results. Maintenance of dose intensity is also essential in order to compare the daily routine with the efficacy and safety results of clinical trials.
authors.affiliation: Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary. dr.aniko.maraz@gmail.com.
authors.forename: Anikó
authors.initials: A
authors.lastname: Maráz
authors.affiliation: Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary. dr.aniko.maraz@gmail.com.
authors.forename: Adrienn
authors.initials: A
authors.lastname: Cserháti
authors.affiliation: Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary. dr.aniko.maraz@gmail.com.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Uhercsák
authors.affiliation: Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary. dr.aniko.maraz@gmail.com.
authors.forename: Eva
authors.initials: E
authors.lastname: Szilágyi
authors.affiliation: Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary. dr.aniko.maraz@gmail.com.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Varga
authors.affiliation: Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary. dr.aniko.maraz@gmail.com.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Kahán
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D060831:Hand-Foot Syndrome / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D007037:Hypothyroidism / Q000139:chemically induced*; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects*; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D013280:Stomatitis / Q000139:chemically induced; D000077210:Sunitinib; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib