Department of Urology, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam, Kyunggi-do 463-707, Republic of Korea.
Jpn J Clin Oncol. 2012 Apr;42(4):314-7. doi: 10.1093/jjco/hys002. Epub 2012 Feb 9.
To investigate the effects of sunitinib treatment on blood glucose levels in patients with metastatic renal cell carcinoma.
We reviewed the records of 48 patients who received sunitinib treatment for metastatic renal cell carcinoma between April 2007 and December 2010 at our institution. Patients' data including diabetic status, diabetes mellitus medication and mean blood glucose levels before, during and after the treatment with sunitinib were assessed.
In 10 of the 48 (20.8%) patients who were diabetic, the blood glucose level was observed to be significantly decreased after 4 weeks of sunitinib treatment with the mean decrease in blood glucose level being 76.1 ± 29.0 mg/dl (P = 0.002). Subsequently, after a 2-week off-treatment period, the mean blood glucose level rebound and increased (21.9 ± 6.3 mg/dl, P = 0.038) in these 10 patients. With sunitinib treatment, one patient was able to discontinue diabetes mellitus medication completely during a 4-week treatment period, and three other patients had dosages of their oral diabetes mellitus medication reduced. Among 38 non-diabetic patients, no significant changes in blood glucose levels were observed during both the 4-week sunitinib treatment period and the 2-week off-treatment period. No severe hypoglycemic episode was observed among our subjects.
Sunitinib treatment in diabetic patients with metastatic renal cell carcinoma may result in significantly decreased blood glucose levels. Thus, blood glucose levels should be checked more vigilantly in diabetic patients undergoing sunitinib treatment to adjust diabetes mellitus medications as needed. Further investigation via a larger scaled, prospective study would be needed.
探讨舒尼替尼治疗转移性肾细胞癌患者血糖水平的影响。
我们回顾了 2007 年 4 月至 2010 年 12 月在我院接受舒尼替尼治疗转移性肾细胞癌的 48 例患者的记录。评估了患者的资料，包括糖尿病状态、糖尿病药物治疗以及舒尼替尼治疗前、治疗期间和治疗后的平均血糖水平。
在 10 例（20.8%）糖尿病患者中，舒尼替尼治疗 4 周后血糖水平明显下降，平均下降 76.1±29.0mg/dl（P=0.002）。随后，在 2 周停药期间，这 10 例患者的平均血糖水平反弹并升高（21.9±6.3mg/dl，P=0.038）。在舒尼替尼治疗期间，1 例患者能够在 4 周的治疗期间完全停止使用糖尿病药物，3 例其他患者减少了口服糖尿病药物的剂量。在 38 例非糖尿病患者中，在舒尼替尼治疗的 4 周期间和停药的 2 周期间，血糖水平均无明显变化。我们的研究对象中没有观察到严重的低血糖事件。
舒尼替尼治疗转移性肾细胞癌合并糖尿病患者可能导致血糖水平显著下降。因此，接受舒尼替尼治疗的糖尿病患者应更密切地检查血糖水平，根据需要调整糖尿病药物治疗。需要进一步进行更大规模、前瞻性研究。
