Treatment of Metastatic Renal Cell Cancer with Sunitinib During Chronic Hemodialysis

Zastrow, Stefan; Froehner, Michael; Platzek, Ivan; Wirth, Manfred P.

doi:10.1016/j.urology.2008.10.028

Cited by 14 publications

(12 citation statements)

References 6 publications

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“…For a comparison with the toxicities of sunitinib in patients with normal renal function, we also presented the frequency of adverse events in patients with normal renal function from a list of reference literature. Although our sample size was too small, the incidence of severe toxicities from sunitinib was not increased in CKD patients compared to those in patients who had preserved kidney function, which was in accordance with previous studies [24,25] .…”

Section: Discussionsupporting

confidence: 91%

“…Zastrow et al [25] previously reported the efficacy of sunitinib in 2 patients during chronic hemodialysis; 1 patient showed a complete response after 5 cycles of sunitinib (the dose was initially 25 mg/day and was increased to 37.5 mg/day after 2 treatment cycles), and another patient had SD after 13 cycles of therapy (the dose was initially 25 mg/day of sunitinib, 37.5 mg/day was used during second cycle, and the dose was increased to 50 mg/day from the third treatment cycle on). From the literature on 1 hemodialyzed patient with sunitinib treatment, Reckova et al [26] reported that the patient showed a PR after the fourth treatment cycle (27 and 37.5 mg/day during the first and second treatment cycles, respectively, and 50 mg/day during the third and fourth treatment cycles), during which treatment had to be stopped because of cardiac toxicity.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Hemodialyzed Patients with Sunitinib in Renal Cell Carcinoma

et al. 2010

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Background: Understanding the effect of adverse events from commonly used agents such as sunitinib in hemodialyzed renal cell carcinoma (RCC) patients is important in clinical practice. Despite its clinical relevance, little information has been provided on the safety and toxicity profile of sunitinib when administered in hemodialyzed patients with RCC. Methods: Six patients undergoing hemodialysis were treated with sunitinib for metastatic RCC between February 2007 and May 2009. We retrospectively reviewed the medical records of these patients and examined the administered dose of sunitinib, treatment-related toxicity, and the clinical response to therapy. Results: The initial dose of sunitinib was 25 mg (cases 1 and 5), 37.5 mg (cases 2 and 3), and 50 mg (cases 4 and 6), respectively. Toxicities greater than grade 3 were observed in cases 3 and 6, and subsequently the dose was reduced in case 6. No patient had to stop sunitinib due to toxicities. Among the 6 patients, 3 (cases 2, 3, and 5) had disease progression after 1, 2, and 2 cycles of sunitinib, respectively. Three patients (cases 1, 4, and 6) had stable disease after 12, 5, and 4 cycles of treatment, respectively, and 2 of them (cases 4 and 6) were still on sunitinib 8 and 7 months, respectively, after the start of treatment. Conclusions: The toxicity of and response to sunitinib in dialyzed patients seem to be comparable to those in patients with normal renal function. However, due to the limitations of this study, i.e. a small number of participants and lack of pharmacokinetic data, prospective clinical trials with pharmacokinetic studies in a larger cohort of patients are required.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Treatment of Hemodialyzed Patients with Sunitinib in Renal Cell Carcinoma

et al. 2010

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“…After six cycles, the multiple metastases in the lung showed a complete response as assessed by computed tomography scan. Our experience is consistent with a recent case study demonstrating that the pharmacokinetics of standard dose sunitinib and its metabolite do not change in patients with ESRD on hemodialysis [6,7]. According to the data of Motzer et al [5] 31% of mRCC cases gave a partial response to sunitinib, and 48% were stable, but no complete response was observed.…”

Section: Discussionsupporting

confidence: 91%

Successful sunitinib treatment of metastatic renal cell carcinoma in a patient with end stage renal disease on hemodialysis

Park¹

2009

Anti-Cancer Drugs

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“…Patients with RCC who have undergone nephrectomy can develop chronic renal failure and require hemodialysis more frequently than is the case in normal populations. The long-term treatment outcomes and tolerability of sunitinib in patients on hemodialysis have recently been evaluated in several case series [2-5]. …”

Section: Discussionmentioning

confidence: 99%

“…However, those trials excluded patients with chronic renal failure who were undergoing dialysis. Recently, the sunitinib tolerance and oncologic outcomes of dialysis patients have been explored in several case series [2-5]. The appropriate dose of and dosing schedule for sunitinib have yet to be established in mRCC patients on hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

Intolerance to Sunitinib Treatment in Hemodialysis Patients With Metastatic Renal Cell Carcinoma

et al. 2014

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Sunitinib is a multiple tyrosine kinase receptor inhibitor that is approved for the treatment of metastatic renal cell carcinoma (RCC). However, neither an appropriate dose nor dosing schedule of sunitinib has yet been established for patients with metastatic RCC who are on hemodialysis. Here, we report on two hemodialysis patients who received sunitinib to treat metastatic RCC. Sunitinib was planned to be administered at a dosage of 25 mg/d for 4 of every 6 weeks. Although sunitinib toxicity was manageable in one patient, disease progression occurred after 4 months of treatment. In the second patient, acute pulmonary edema, caused by uncontrolled hypertension, developed on the 15th day of sunitinib therapy and the drug had to be discontinued. Sunitinib is thus not well tolerated in a hemodialysis setting. Close monitoring of toxicity and dose manipulation may be required if such therapy is attempted.

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Treatment of Metastatic Renal Cell Cancer with Sunitinib During Chronic Hemodialysis

Cited by 14 publications

References 6 publications

Treatment of Hemodialyzed Patients with Sunitinib in Renal Cell Carcinoma

Treatment of Hemodialyzed Patients with Sunitinib in Renal Cell Carcinoma

Successful sunitinib treatment of metastatic renal cell carcinoma in a patient with end stage renal disease on hemodialysis

Intolerance to Sunitinib Treatment in Hemodialysis Patients With Metastatic Renal Cell Carcinoma

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