Management of sunitinib adverse events in renal cell carcinoma patients: The Asian experience
- 24 April 2012
- journal article
- review article
- Published by Wiley in Asia-Pacific Journal of Clinical Oncology
- Vol. 8 (2), 132-144
- https://doi.org/10.1111/j.1743-7563.2012.01525.x
Abstract
Sunitinib is the gold standard of care for patients with metastatic renal cell carcinoma, demonstrating an overall survival benefit of over 2 years in a pivotal phase 3 trial of 750 patients. While sunitinib is generally well tolerated with most adverse events, manifesting as mild to moderate in severity and manageability, it has a distinctive adverse event profile that benefits from careful monitoring during treatment. As sunitinib gains widespread use across the globe, best practices are being developed for specific patient groups. This review will focus on the current clinical trial data in Asian populations and on the mechanism, incidence and management of selected sunitinib-related adverse events, including hand-foot syndrome, hypertension, proteinuria, cardiac toxicities, myelosupression, fatigue/asthenia, hypothyroidism, diarrhea and hepatotoxicity. Taken together, the developing body of literature reviewed here demonstrates that sunitinib is well tolerated in Asian patients and provides efficacy that is similar, if not superior, to other patient groups. Asian patients, like all patients, should begin treatment of sunitinib at 50 mg on Schedule 4/2 (4 weeks on treatment/2 weeks off). Prophylactic measures, good communication between patient and health-care providers, and early, aggressive intervention at the development of adverse events can limit the dose reductions required and maximize both patients' response to treatment and their quality of life.Keywords
This publication has 46 references indexed in Scilit:
- Kidney Cancer Working Group ReportJapanese Journal of Clinical Oncology, 2010
- Sunitinib for unselected Korean patients with advanced renal cell carcinoma: A comparable efficacy with different toxicity profiles.Journal of Clinical Oncology, 2010
- The Efficacy and Safety of Sunitinib in Korean Patients with Advanced Renal Cell Carcinoma: High Incidence of Toxicity Leads to Frequent Dose ReductionJapanese Journal of Clinical Oncology, 2010
- Relationship between exposure to sunitinib and efficacy and tolerability endpoints in patients with cancer: results of a pharmacokinetic/pharmacodynamic meta-analysisCancer Chemotherapy and Pharmacology, 2009
- 7118 An Asian subpopulation analysis of the safety and efficacy of sunitinib in metastatic renal cell carcinomaEuropean Journal of Cancer Supplements, 2009
- Overall Survival and Updated Results for Sunitinib Compared With Interferon Alfa in Patients With Metastatic Renal Cell CarcinomaJournal of Clinical Oncology, 2009
- Safety and efficacy of sunitinib for metastatic renal-cell carcinoma: an expanded-access trialThe Lancet Oncology, 2009
- Treatment Outcomes of Sunitinib Treatment in Advanced Renal Cell Carcinoma Patients: A Single Cancer Center Experience in KoreaCancer Research and Treatment, 2009
- Quality of Life in Patients With Metastatic Renal Cell Carcinoma Treated With Sunitinib or Interferon Alfa: Results From a Phase III Randomized TrialJournal of Clinical Oncology, 2008
- Global Cancer Statistics, 2002CA: A Cancer Journal for Clinicians, 2005