title: Complete remission with sunitinib in a poor-risk patient with metastatic renal cell carcinoma: the fine balance between toxicity and efficacy.
abstract: Sunitinib represents a reasonable therapeutic option for first-line treatment of poor-risk metastatic renal cell carcinoma and the treatment should aim at the delicate balance between managing side effects to improve the toxicity profile and patient compliance to treatment while maintaining anticancer efficacy. Achievement of a complete response, although rare, is possible, even in poor-risk patients. Treatment discontinuation represents a viable alternative for both tumour biology and patients' quality of life. To date, no molecular markers have been identified with prognostic and/or predictive value for guiding therapeutic decisions. Further research should aim at gaining in-depth knowledge of renal cell carcinoma biology for a tailored personalized therapy. We report a case of poor-risk metastatic renal cell carcinoma, with Von Hippel-Lindau loss of function, which achieved and maintained a complete remission after first-line therapy with sunitinib by using a reduced dosage and a modified schedule of treatment.
authors.affiliation: Departments of aMedical Oncology bPathology and Diagnostics cUrology Clinic, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona dApplied Research on Cancer Network (ARC-NET) and Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Massari
authors.forename: Chiara
authors.initials: C
authors.lastname: Ciccarese
authors.forename: Davide
authors.initials: D
authors.lastname: Bimbatti
authors.forename: Emanuela
authors.initials: E
authors.lastname: Fantinel
authors.forename: Alessandra
authors.initials: A
authors.lastname: Modena
authors.forename: Michele
authors.initials: M
authors.lastname: Simbolo
authors.forename: Matteo
authors.initials: M
authors.lastname: Brunelli
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.forename: Guido
authors.initials: G
authors.lastname: Martignoni
authors.forename: Aldo
authors.initials: A
authors.lastname: Scarpa
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Tortora
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000235:genetics / Q000556:secondary; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage* / Q000009:adverse effects; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D009154:Mutation; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011758:Pyrroles / Q000008:administration & dosage* / Q000009:adverse effects; D012074:Remission Induction; D012306:Risk; D000077210:Sunitinib; D051794:Von Hippel-Lindau Tumor Suppressor Protein / Q000235:genetics
chemical_list: D020533:Angiogenesis Inhibitors; D007211:Indoles; D011758:Pyrroles; D051794:Von Hippel-Lindau Tumor Suppressor Protein; D011505:Protein-Tyrosine Kinases; C497446:VHL protein, human; D000077210:Sunitinib