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舒尼替尼治疗韩国晚期肾细胞癌患者的疗效和安全性:高毒性发生率导致频繁剂量减少。

The efficacy and safety of sunitinib in korean patients with advanced renal cell carcinoma: high incidence of toxicity leads to frequent dose reduction.

机构信息

Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul 138-736, Republic of Korea.

出版信息

Jpn J Clin Oncol. 2010 Oct;40(10):980-5. doi: 10.1093/jjco/hyq073. Epub 2010 May 10.

DOI:10.1093/jjco/hyq073
PMID:20457723
Abstract

OBJECTIVE

The effects of sunitinib in a broad patient population, especially those of Asian ethnicity, have been rarely investigated. Here, we assessed the efficacy and safety of sunitinib in Korean patients with advanced renal cell carcinoma.

METHODS

Between April 2006 and August 2008, 77 Korean patients with advanced renal cell carcinoma were treated with sunitinib. We performed retrospective analysis for efficacy in terms of survival outcomes and response rate. Toxicity profiles were also assessed.

RESULTS

A total of 65 patients, including 39 (60%) patients without previous cytotoxic or immunotherapy, were eligible for the analysis. In 53 patients with measurable lesions, the objective response rate was 43% and disease control was achieved in 46 (86%) patients. The median time to treatment failure, time to progression and overall survival were 7.0, 11.8 and 22.8 months, respectively, with a median follow-up of 26.8 months in surviving patients. The most common treatment-related adverse events were fatigue (81%) and stomatitis (60%). The most common Grade 3 or 4 adverse events were hand-foot syndrome (16%), thrombocytopenia (16%) and stomatitis (10%). Dose reduction was required in 46% of patients.

CONCLUSIONS

The efficacy was similar to a previous Phase III trial and a safety profile of sunitinib was manageable in Korean patients with advanced renal cell carcinoma, although the incidence of dose reduction and Grade 3 or 4 adverse events were higher than those of western reports. Future studies should investigate the ethnic differences in toxicity profiles of sunitinib.

摘要

目的

舒尼替尼在广泛的患者群体中的疗效,尤其是在亚洲人群中的疗效,鲜有研究报道。在此,我们评估了舒尼替尼在韩国晚期肾细胞癌患者中的疗效和安全性。

方法

2006 年 4 月至 2008 年 8 月,77 例韩国晚期肾细胞癌患者接受了舒尼替尼治疗。我们对生存结果和缓解率进行了回顾性分析。同时评估了毒性特征。

结果

共有 65 例患者(包括 39 例既往未接受细胞毒性或免疫治疗的患者)符合分析条件。在 53 例可测量病灶患者中,客观缓解率为 43%,46 例(86%)患者疾病得到控制。中位无治疗失败时间、中位进展时间和中位总生存期分别为 7.0、11.8 和 22.8 个月,生存患者的中位随访时间为 26.8 个月。最常见的治疗相关不良事件为乏力(81%)和口腔炎(60%)。最常见的 3 级或 4 级不良事件为手足综合征(16%)、血小板减少症(16%)和口腔炎(10%)。46%的患者需要减少剂量。

结论

舒尼替尼在韩国晚期肾细胞癌患者中的疗效与之前的 III 期临床试验相似,安全性可管理,但剂量减少和 3 级或 4 级不良事件的发生率高于西方报告。未来的研究应探讨舒尼替尼毒性特征的种族差异。

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