BERKELEY, CA (UroToday.com) - Sunitinib is a highly potent, selective inhibitor of certain protein tyrosine kinases, including VEGF-R types 1 to 3, PDGF-R- , and PDGF-R-ß. Preclinical data suggest that sunitinib has antitumor activity that may result from both inhibition of angiogenesis and direct antiproliferative effects on certain tumor cell types. Phase-2 clinical trial data have reported an overall response rate to Sunitinib of 39% with 23% of these patients having stable disease of at least 3 months. Furthermore, it has been shown that the median progession free survival was 11 months for patients on sunitinib versus 5 months for patients on Interferon-alpha. Sunitinib produced an overall response rate of 31% versus 6% associated with IFNA (P less than.000001), with an acceptable safety profile. Sunitinib is currently approved for the treatment of metastatic renal cell carcinoma, with studies underway to evaluate its value in the neoadjuvant and adjuvant setting.

Currently, sunitinib’s therapeutic effect is measured by the decrease in the size of the primary or metastatic tumor radiographically, with no correlative pathologic information. In this manuscript, we discuss a patient with renal cell carcinoma who developed a renal fossa recurrence 2 years following radical nephrectomy. Tumor shrinkage was evident in the nephrectomy bed after treatment with sunitinib. The pathology of the resected retroperitoneal mass and its implications are discussed. To our knowledge, this is the first pathological evidence of the extensive necrotic effect of sunitinib on renal cell carcinoma (RCC). This case suggests that tyrosine kinase inhibitors like sunitinib may serve as useful adjuncts to surgical resection of metastatic and locally advanced RCC.

Written by
Amr Fergany, MD, as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

Pathological Evidence of Necrosis in Recurrent Renal Mass Following Treatment with Sunitinib - Abstract

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