On-target Toxicities Predictive of Survival in Metastatic Renal Cell Carcinoma (mRCC) Treated With Sunitinib: A Multicenter Retrospective Study.

Preliminary studies suggested that selected drug-related toxicities of sunitinib may correlate with a better prognosis.

From January 2006 through December 2015, we retrospectively analyzed data of 145 patients with metastatic renal cell carcinoma treated with sunitinib as a first-line therapy in 7 different Italian oncology departments. Hypertension, hypothyroidism, thrombocytopenia, neutropenia, and anemia were evaluated. Overall survival (OS) and progression-free survival (PFS) were calculated. OS and PFS were compared in patients who developed and who did not develop a drug-related toxicity. A multivariate analysis using the Cox regression model was performed.

We evaluated 145 patients (92 males; median age, 70 years); 105 (62.4%) patients experienced at least 1 toxicity: 66 (45.5%) patients developed hypothyroidism, 41 (28.3%) thrombocytopenia, 39 (26.9%) hypertension that required medical therapy, 22 (15.2%) anemia, and 11 (7.6%) neutropenia. The median PFS of patients who developed hypertension was 12 months (95% confidence interval [CI], 9-21 months) versus 9 months (95% CI, 7-12 months) in patients who did not develop toxicity; the median OS was 36 months (95% CI, 22 months to not reached) versus 26 months (95% CI, 18-34 months). For neutropenia, the median PFS was 17.5 months (95% CI, 9-65 months) versus 10 months (95% CI, 8-12 months); the median OS was 23 months (95% CI, 13 months to not reached) versus 28 months (95% CI, 22-35 months). At univariate and multivariate analysis, we observed a protective effect of hypertension and neutropenia on tumor progression (hazard ratio, 0.47; 95% CI, 0.28-0.78 and hazard ratio, 0.26; 95% CI, 0.09-0.76, respectively).

Many patients developed toxicities during treatment with sunitinib; hypertension and neutropenia were related to longer PFS in our cohort.

Clinical genitourinary cancer. 2019 Dec 05 [Epub ahead of print]

Elena Bolzacchini, Graziella Pinotti, Lorenza Bertù, Claudio Verusio, Luca Galli, Nicola Mumoli, Cecilia Barbara, Marco Danova, Marco Bregni, Salvatore Artale, Chiara Rossini, Olga Nigro, Andrea Antonuzzo, Lisa Derosa, Martina Torchio, Sabrina Barzaghi, Isabella Ricci, Matteo Suter, Alice Ballerio, Ilaria Vallini, Francesco Dentali

U.O. Oncologia, Ospedale Sant'Anna, ASST-LARIANA, Como, Italy; Università degli studi dell'Insubria di Varese, Varese, Italy. Electronic address: ., Oncologia Medica, Ospedale di Circolo, Varese, Italy., Dipartimento di Medicina e Chirurgia, Università degli Studi dell'Insubria di Varese, Varese, Italy., Oncologia Medica, Presidio Ospedaliero di Saronno, Saronno, Italy., Oncologia Medica, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy., Medicina Interna, Azienda USL6 Livorno - Presidio Ospedaliero di Livorno, Livorno, Italy., Oncologia Medica, Azienda USL 6 di Livorno, Livorno, Italy., Medicina Interna ad indirizzo Oncologico, Ospedale di Vigevano, Azienda Socio-Sanitaria Territoriale di Pavia, Pavia, Italy., Oncologia Medica, Ospedale di Busto Arsizio - ASST Valle Olona, Busto Arsizio, Italy., Oncologia Medica, Azienda Ospedaliera S. Antonio Abate di Gallarate, Gallarate, Italy.