Biochemical and Pathological Response of Prostate Cancer in a Patient with Metastatic Renal Cell Carcinoma on Sunitinib Treatment

Abstract

Sunitinib is a small molecular inhibitor of tyrosine kinases and is used to treat advanced renal cell carcinoma and gastrointestinal stromal tumour after disease progression or intolerance to imatinib therapy. Here, we describe biochemical and pathological response of prostate cancer in a patient with metastatic renal cell carcinoma during sunitinib treatment. A 62-year-old man was referred to our hospital because of a mass in the scalp. He was diagnosed with left renal cell carcinoma with right renal and scalp metastases. In addition, synchronous prostate cancer involving less than one-half of the right lobe was found with a prostate-specific antigen (PSA) value of 23.4 ng/ml. Treatment was begun with sunitinib (50 mg daily, 4 weeks on and 2 weeks off). Regarding the prostate cancer, active monitoring was planned considering the far advanced renal cell carcinoma. Surprisingly, the PSA level was 3.4 ng/ml at week 6 and 0.2 ng/ml at week 12, and it subsequently remained normal. At the time of writing (cycle 6 of sunitinib therapy), the prostate nodule significantly decreased in size. Furthermore, a 12-core re-biopsy revealed pathological evidence of regression with sunitinib treatment, with control of his renal cell carcinoma.

Alopecia neoplastica as a sign of visceral malignancies: a systematic review

“…Women were more represented with the 53.7% (66/123) of cases, compared to the 46.3% (57/123) of men . Median age of AN at onset was 59 (IQR: 47–68).…”

“…According to gender distribution of primary tumours, we obviously found that the 100% of patients with uterus cancer (8/ 8) 64,65,84 while in 24.8% (30/121) cases, the diagnosis was synchronous. 7,8,18,20,23,31,33,35,44,46,48,56,68,69,72,73,[76][77][78]81,84,87,93,95,96,99,102,110,111 The specific sites of primary tumours in each of these subgroups were reported in Table S1 (Supporting Information). Considering cases diagnosed after the primary tumour, they were mainly derived from breast and GI cancers (18/88 cases each); synchronous cases prevalently had a GI origin (10/30 cases), while cases diagnosed before the primary tumour were only three (one from GI, namely one thyroid and one lung cancer).…”

“…Regarding clinical appearance, AN was identified as a nodule, plaque and patch in 58% (69/119), 8,9,21,22,24,27,33,34,37-41,43,44,46,47,49- 2,6,7,11,[14][15][16][17][18][19][20]23,25,29,67,96 respectively; under the general term of a 'mass' in 16.8% (20/119) 28,32,35,42,45,48,58,59,71,73,80,81,83,87,95,106,110,111,114,117 and as an 'excoriated lesion' in 2.5% (3/119) of cases. 69,78,109 Specifically, breast cancer was mainly associated with patch lesions (9/20), followed by plaques and nodules (five and five out of 20, respectively).…”

“…10,30,37,44,52,56,66,77 When reported, AN was asymptomatic in the majority of cases (78%; 21/27), with pain being reported in 22% of cases (6/27 cases). 21,32,42,56,69,117 According to the site on the scalp, in the majority of cases (70/94) only one site was involved, being the parietal area the most frequently reported with 19 cases, 30,31,33,35,45,48,50,55,69,78,[92][93][94][95]104,106,107,110,116 followed by the frontal with 18 cases, 2,[7][8][9]16,38,42,44,52,65,[80][81][82]98,114,[117][118]…”

“…Treatment of the primary tumour was reported in 84 performed treatment (alone in 23 cases; combined with surgery or radiotherapy, respectively, in 11 and 10 cases), followed by surgery (alone in 24 cases; combined with chemotherapy or radiotherapy, respectively, in 11 and three cases). 2,4,8,13,20,[22][23][24][29][30][31]33,[35][36][37][38][39]51,53,54,66,67,76,77,80,84,93,95,99,104,109,110,112,115…”