To date no systematic review has been performed until now about the outcome and safety of sorafenib in patients affected by metastatic renal cell carcinoma (mRCC) undergoing hemodialysis. Further little data are available in the literature, and none are truly clinically useful providing information on the management of the drug and its adverse events by clinicians.
These patients are always excluded from clinical trials, due to their altered pharmacokinetics and expectancy of increased drug toxicity; and since it results in difficult medical decisions and mistakes in drug dosing. The need for performing a systematic review about this issue arose from the lack of a common information on the topic. We undertook this review with the aim to provide practical information for the daily management of sorafenib. We evaluated all the literature about mRCC dialysis patients receiving sorafenib and we performed a systematic review according to PRISMA guidelines. Also, one patient from our department was included. Our results confirmed the efficacy of sorafenib in dialysis patients, but at the expense of increased drug toxicity. According to our findings we suggest to use sorafenib with caution in mRCC dialysis patients, and starting the treatment with reduced doses (ie, 400 mg/die).
This Beyond the Abstract was written by: Buti, S. Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
Commentary on Clin Genitourin Cancer. 2016 Jan 28. pii: S1558-7673(16)30010-6. doi: 10.1016/j.clgc.2016.01.010. [Epub ahead of print]
Leonetti A1, Bersanelli M1, Castagneto B2, Masini C3, Di Meglio G4, Pellegrino B1, Buti S5.
1Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
2Department of Oncology, San Giacomo Hospital Novi Ligure, Alessandria, Italy.
3Division of Medical Oncology, University Hospital of Modena, Modena, Italy.
4Medical Oncology Unit, Hospital of Bolzano, Bolzano, Italy.
5Medical Oncology Unit, University Hospital of Parma, Parma, Italy.