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Sunitinib for advanced renal cell cancer.

Coppin C - Biologics (2008)

Bottom Line: In patients with the clear-cell subtype of renal cell cancer and metastatic disease with good or moderate prognostic factors for survival, sunitinib 50 mg for 4 weeks of a 6-week cycle provides superior surrogate and patient-reported outcomes when compared with interferon-alfa, the previous commonly used first-line drug.Toxicity is significant but manageable with experienced monitoring.High cost and limited efficacy support the ongoing search for further improved therapy.

View Article: PubMed Central - PubMed

Affiliation: BC Cancer Agency and University of British Columbia, Vancouver, Canada.

ABSTRACT
Renal cell cancer has been refractory to drug therapy in the large majority of patients. Targeted agents including sunitinib have been intensively evaluated in renal cell cancer over the past 5 years. Sunitinib is an oral small molecule inhibitor of several targets including multiple tyrosine kinase receptors of the angiogenesis pathway. This review surveys the rationale, development, validation, and clinical use of sunitinib that received conditional approval for use in North America and Europe in 2006. In patients with the clear-cell subtype of renal cell cancer and metastatic disease with good or moderate prognostic factors for survival, sunitinib 50 mg for 4 weeks of a 6-week cycle provides superior surrogate and patient-reported outcomes when compared with interferon-alfa, the previous commonly used first-line drug. Overall survival has not yet shown improvement over interferon and is problematic because of patient crossover from the control arm to sunitinib at disease progression. Toxicity is significant but manageable with experienced monitoring. Sunitinib therapy is an important step forward for this condition. High cost and limited efficacy support the ongoing search for further improved therapy.

No MeSH data available.


Related in: MedlinePlus

Kaplan – Meier estimates of progression-free survival (independent central review). Reproduced with permission from Motzer RJ, Hutson TE, Tomczak P, et al 2007a. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med, 356:115–24. Copyright © 2007 Massachusets Medical Society. All rights reserved.
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f1-btt-2-97: Kaplan – Meier estimates of progression-free survival (independent central review). Reproduced with permission from Motzer RJ, Hutson TE, Tomczak P, et al 2007a. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med, 356:115–24. Copyright © 2007 Massachusets Medical Society. All rights reserved.

Mentions: Independently assessed progression-free survival, the primary endpoint, was substantially better with sunitinib than interferon alfa (Figure 1). As of February 2007 (Motzer et al 2007b), the updated median progression-free survival was 11.0 months for sunitinib versus 5.1 months for interferon alfa, hazard ratio 0.54 (95% CI 0.44–0.66; p < 10−6). Multivariate analysis of the sunitinib arm found that diagnosis to treatment interval of less than a year, reduced patient performance status, and corrected serum calcium >10 mg/dL were independent predictors of worse progression-free survival (Motzer et al 2007b).


Sunitinib for advanced renal cell cancer.

Coppin C - Biologics (2008)

Kaplan – Meier estimates of progression-free survival (independent central review). Reproduced with permission from Motzer RJ, Hutson TE, Tomczak P, et al 2007a. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med, 356:115–24. Copyright © 2007 Massachusets Medical Society. All rights reserved.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2727778&req=5

f1-btt-2-97: Kaplan – Meier estimates of progression-free survival (independent central review). Reproduced with permission from Motzer RJ, Hutson TE, Tomczak P, et al 2007a. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med, 356:115–24. Copyright © 2007 Massachusets Medical Society. All rights reserved.
Mentions: Independently assessed progression-free survival, the primary endpoint, was substantially better with sunitinib than interferon alfa (Figure 1). As of February 2007 (Motzer et al 2007b), the updated median progression-free survival was 11.0 months for sunitinib versus 5.1 months for interferon alfa, hazard ratio 0.54 (95% CI 0.44–0.66; p < 10−6). Multivariate analysis of the sunitinib arm found that diagnosis to treatment interval of less than a year, reduced patient performance status, and corrected serum calcium >10 mg/dL were independent predictors of worse progression-free survival (Motzer et al 2007b).

Bottom Line: In patients with the clear-cell subtype of renal cell cancer and metastatic disease with good or moderate prognostic factors for survival, sunitinib 50 mg for 4 weeks of a 6-week cycle provides superior surrogate and patient-reported outcomes when compared with interferon-alfa, the previous commonly used first-line drug.Toxicity is significant but manageable with experienced monitoring.High cost and limited efficacy support the ongoing search for further improved therapy.

View Article: PubMed Central - PubMed

Affiliation: BC Cancer Agency and University of British Columbia, Vancouver, Canada.

ABSTRACT
Renal cell cancer has been refractory to drug therapy in the large majority of patients. Targeted agents including sunitinib have been intensively evaluated in renal cell cancer over the past 5 years. Sunitinib is an oral small molecule inhibitor of several targets including multiple tyrosine kinase receptors of the angiogenesis pathway. This review surveys the rationale, development, validation, and clinical use of sunitinib that received conditional approval for use in North America and Europe in 2006. In patients with the clear-cell subtype of renal cell cancer and metastatic disease with good or moderate prognostic factors for survival, sunitinib 50 mg for 4 weeks of a 6-week cycle provides superior surrogate and patient-reported outcomes when compared with interferon-alfa, the previous commonly used first-line drug. Overall survival has not yet shown improvement over interferon and is problematic because of patient crossover from the control arm to sunitinib at disease progression. Toxicity is significant but manageable with experienced monitoring. Sunitinib therapy is an important step forward for this condition. High cost and limited efficacy support the ongoing search for further improved therapy.

No MeSH data available.


Related in: MedlinePlus