Porcu, Chiara (2010) Gli Inibitori tirosin-kinasici nel trattamento del carcinoma renale. Doctoral Thesis.
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Aim: Vascular endothelial growth factor receptor (VEGFR) is a rational targets for new anticancer therapy. Sunitinib, a multitargeted receptor tyrosin-kinase inhibitors, has demonstrated improved in efficacy in patients with metastatic renal cell carcinoma (mRCC).
This study assess efficacy and safety of Sunitinib in non selected mRCC patients (pts) and evaluates, by immunohistochemical analysis, correlation between VEGFR expression, prognosis and treatment’s response.
Methods: pts with metastatic RCC were enrolled to recive Sunitinib 50 mg orally once daily for 4 weeks followed by 2 weeks off, until disease progression or unacceptable toxicity. Primary endpoint was progression free survival (PFS) and response rate (RR). Immunohistochemical was performed with antibodies directed against VEGF receptors and other molecular markers.
Results: 14 pts were included: The median age was 61 yrs. All pts received the reccomended starting dose of 50 mg once daily. Ten pts were evaluated for the response. RR is 60%. The median PFS was 9 months. The most common grade 3 adverse event (AE) was asthenia and hand-foot syndrome and 50% pts required dose reduction. Immunohistochemical evaluation of VEGFR is ongoing.
Conclusion: Sunitinib improves PFS and RR either in non selected pts but a significant percentage requires dose-reduction The first 4 weeks of treatment seem to be the most likely timeframe within which drug reactions occur. Careful monitoring and additional clinical visits are warranted during this time period.
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