title: Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian National Cancer Institute (INCA) experience.
abstract: OBJECTIVE
  The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC) treated by the Brazilian Unified Health System (SUS) at a single reference institution.
  
  
  METHODS
  Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013.
  
  
  RESULTS
  Fifty-eight patients were eligible. Most patients were male 41 (71%), with a median age of 58 years. Nephrectomy was performed in 41 (71%) patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2%) patients. In 50 patients (86%), sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%), hypothyroidism (43%), mucositis (33%) and diarrhea (29%). Grade 3 and 4 adverse effects were infrequent: fatigue (12%), hypertension (12%), thrombocytopenia (7%), neutropenia (5%) and hand-foot syndrome (5%). Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months.
  
  
  CONCLUSIONS
  Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS.
authors: Departamento de Oncologia Clínica. Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil.
authors: Rafael Corrêa
authors: RC
authors: Coelho
authors: Departamento de Oncologia Clínica. Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil.
authors: Tomás
authors: T
authors: Reinert
authors: Departamento de Urologia - Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil.
authors: Franz
authors: F
authors: Campos
authors: Departamento de Oncologia Clínica. Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil.
authors: Fábio Affonso
authors: FA
authors: Peixoto
authors: Departamento de Oncologia Clínica. Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil.
authors: Carlos Augusto
authors: CA
authors: de Andrade
authors: Departamento de Estatística - Centro de Pesquisa Clínica (CPQ) - Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil.
authors: Thalita
authors: T
authors: Castro
authors: Departamento de Oncologia Clínica. Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil.
authors: Daniel
authors: D
authors: Herchenhorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001938:Brazil; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary; D018572:Disease-Free Survival; D005260:Female; D006078:Government Programs; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D011758:Pyrroles / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077210:Sunitinib; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib
keywords: Kidney Neoplasms; Neoplasm Metastasis; sunitinib [Supplementary Concept]