The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC) treated by the Brazilian Unified Health System (SUS) at a single reference institution.
Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013.
Fifty-eight patients were eligible. Most patients were male 41 (71%), with a median age of 58 years. Nephrectomy was performed in 41 (71%) patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2%) patients. In 50 patients (86%), sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%), hypothyroidism (43%), mucositis (33%) and diarrhea (29%). Grade 3 and 4 adverse effects were infrequent: fatigue (12%), hypertension (12%), thrombocytopenia (7%), neutropenia (5%) and hand-foot syndrome (5%). Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months.
Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS.
International braz j urol : official journal of the Brazilian Society of Urology. 0000 [Epub]
Rafael Corrêa Coelho, Tomás Reinert, Franz Campos, Fábio Affonso Peixoto, Carlos Augusto de Andrade, Thalita Castro, Daniel Herchenhorn
Departamento de Oncologia Clínica. Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil., Departamento de Urologia - Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil., Departamento de Estatística - Centro de Pesquisa Clínica (CPQ) - Instituto Nacional do Câncer José de Alencar Gomes da Silva (INCA), RJ, Brasil.