Long-Term Response and Postsurgical Complete Remissions After Treatment With Sunitinib Malate, an Oral Multitargeted Receptor Tyrosine Kinase Inhibitor, in Patients With Metastatic Renal Cell Carcinoma

• Published in: Cancer investigation 2011-05, Vol.29 (4), p.282-285
• Main Authors: Ayllon, Jorge, Beuselinck, Benoit, Morel, Alexandre, Barrascout, Eduardo, Medioni, Jacques, Scotte, Florian, Oudard, Stéphane
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adrenal Gland Neoplasms - drug therapy; Adrenal Gland Neoplasms - enzymology; Adrenal Gland Neoplasms - secondary; Adrenal Gland Neoplasms - surgery; Adrenal Gland Neoplasms - therapy; Adrenalectomy; Aged; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - adverse effects; Bone Neoplasms - drug therapy; Bone Neoplasms - enzymology; Bone Neoplasms - secondary; Bone Neoplasms - surgery; Bone Neoplasms - therapy; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - enzymology; Carcinoma, Renal Cell - secondary; Carcinoma, Renal Cell - surgery; Carcinoma, Renal Cell - therapy; Chemotherapy, Adjuvant; Dose intensity; Female; Humans; Indoles - administration & dosage; Indoles - adverse effects; Kidney Neoplasms - enzymology; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Long-term efficacy; Lung Neoplasms - drug therapy; Lung Neoplasms - enzymology; Lung Neoplasms - secondary; Lung Neoplasms - surgery; Lung Neoplasms - therapy; Lymph Node Excision; Male; Middle Aged; Molecular Targeted Therapy; Neoplasm Staging; Nephrectomy; Osteotomy; Pneumonectomy; Protein Kinase Inhibitors - administration & dosage; Protein Kinase Inhibitors - adverse effects; Pyrroles - administration & dosage; Pyrroles - adverse effects; Renal cell carcinoma; Sunitinib; Surgical metastasis resection; Time Factors; Treatment Outcome
• ISSN: 0735-7907; 1532-4192
• DOI: 10.3109/07357907.2011.568560

Receptor tyrosine kinase (RTK) inhibitors have revolutionized the treatment of metastatic renal cell carcinoma (mRCC) and significantly extended survival in these patients. Sunitinib is an oral multitargeted inhibitor of vascular endothelial growth factor receptors (VEGFRs-1, -2, and -3), platelet-derived growth factor receptors (PDGFRs-α and -β), stem-cell factor receptor (KIT), FMS-like tyrosine kinase 3 (FLT3), colony-stimulating factor 1 receptor (CSF-1R), and glial cell line-derived neurotrophic factor receptor (REarranged during Transfection; RET). Sunitinib is approved multinationally for the treatment of advanced RCC, and is considered the reference standard of care for first-line treatment. In clinical trials, sunitinib has been associated with a consistent, distinct profile of adverse events. Here we describe three cases that show that it is possible to manage adverse events occurring during sunitinib therapy, and thus allow patients with mRCC to receive an effective dose of sunitinib in order to achieve long-term disease control. These cases also show that surgical resection, performed whenever possible, can help to improve control of metastatic disease and so avoid the unnecessary toxicity and high costs of prolonged antiangiogenic therapy.