Sunitinib Treatment Modification in First-Line Metastatic Renal Cell Carcinoma: Analysis of the STAR-TOR Registry

Abstract

Background/Aim: Sunitinib is the current standard of care for first-line (1L) treatment of metastatic renal cell carcinoma (mRCC). Previous studies suggest that a modified treatment schedule may benefit patients. Our aim was to evaluate efficacy and safety regarding sunitinib treatment modification in 1L treatment of mRCC. Materials and Methods: Data were drawn from STAR-TOR, a German realworld registry to evaluate outcomes of patients with mRCC who received 1L sunitinib. Patients were divided into two groups: subsequent treatment modification (SM) or remaining on standard dose/schedule (SS). Time on treatment (TT), progression-free survival (PFS), and overall survival (OS) were estimated. Results: Overall, 297 patients were analyzed; 33% underwent treatment modification. Significant baseline differences between groups were observed; SM patients were older and had a more favourable Karnofsky performance status. SM patients achieved better outcomes than SS patients for median TT (15.1 versus 3.9 months; p<0.0001), PFS (15.1 versus 6.0; p<0.0001), and OS (38.1 versus 13.7; p<0.0001). Diarrhoea (34%/17%), fatigue (30%/11%), handfoot syndrome (28%/10%), and stomatitis (20%/6%) were more frequently reported in SM versus SS; incidence was reduced following schedule/dose modification (except diarrhoea). Conclusion: In addition to AE mitigation, sunitinib treatment modification may help improve efficacy outcomes in mRCC by prolonging treatment duration.

Sunitinib for Metastatic Renal Cell Carcinoma: A Systematic Review and Meta-Analysis of Real-World and Clinical Trials Data

“…However, the number of patients receiving 2/1 dosing was low (n = 32). A recent analysis of nearly 300 patients from a German registry found that, when compared with 4/2 dosing, sunitinib dose modification reduced the frequency of AEs and significantly increased mPFS (6.0 vs 15.1 months) and OS (13.7 vs 38.1 months) [57]. Notably, patients who received sunitinib dose modification were older, but had a more favorable risk status compared with patients receiving 4/2 dosing, which may explain why these measures fall outside the confidence estimates reported herein.…”

Interval Between Cancer Diagnosis and Radiotherapy – An Independent Prognostic Factor of Survival in Patients Irradiated for Bone Metastases from Kidney Cancer

“…Since the survival of patients with metastatic kidney cancer is poor, a great amount of data from preclinical and clinical research has been gathered (14)(15)(16)(17)(18)(19). In addition to the development of new drugs, personalized treatment is another important approach.…”

Life expectancy in patients with metastatic renal cell carcinoma in the Russian Federation: results of the RENSUR3 multicenter registry study

“…Те же проблемы отмечаются в других странах БРИКС [8,13], в которых только 20 % больных получают вторую линию терапии. В немецком проспективном регистровом исследовании STAR-TOR [14] в группе, получившей последовательную терапию сунитинибом / темсиролимусом и затем акситинибом, медиана ОВ составила 38,1 месяца, а в группе, в которой назначалась только одна линия терапии, -13,7 месяца (P<0,0001). В чешском регистре RENIS назначение двух линий терапии приводило к медиане ОВ 29 месяцев, тогда как получение пациентами трех линий -к 50,9 месяца [15].…”