Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
First Chair and Department of Cardiology, Warsaw Medical University, Warsaw, Poland.
Adv Exp Med Biol. 2019;1133:35-40. doi: 10.1007/5584_2018_328.
Patients with metastatic clear cell renal cell carcinoma (mRCC) typically receive systemic treatment with tyrosine kinase inhibitors (TKI). Side effects include the hand-foot syndrome (HFS), tiredness, nausea, decreased appetite, diarrhea, myelosuppression, and hypertension. This study seeks to define the relationship between the incidence of HFS after the first cycle of treatment with sunitinib as the first-line treatment for mRCC (50 mg/day, 6-week schedule: 4 weeks on and 2 weeks off) and progression-free survival. We found that patients, treated with sunitinib for mRCC, who did not experience HFS had the median progression-free survival of 9.8 months. HFS symptoms appeared in 20% of patients after the first treatment cycle. The appearance of HFS was a predictor of a longer progression-free survival. In fact, progression-free survival was elongated in the HFS group over and beyond the observation period of 60 months, which rendered the median progression-free survival calculation impossible. These findings reaffirm the importance of monitoring skin toxicity during treatment with TKI. We conclude that the appearance of adverse skin symptoms presages better outcomes in patients treated with sunitinib for mRCC.
患有转移性透明细胞肾细胞癌 (mRCC) 的患者通常接受酪氨酸激酶抑制剂 (TKI) 的系统治疗。副作用包括手足综合征 (HFS)、疲劳、恶心、食欲下降、腹泻、骨髓抑制和高血压。本研究旨在定义舒尼替尼作为 mRCC 一线治疗（50mg/天，6 周方案：4 周用药，2 周停药）后第一个治疗周期 HFS 发生率与无进展生存期之间的关系。我们发现，接受舒尼替尼治疗的 mRCC 患者中，未出现 HFS 的患者的中位无进展生存期为 9.8 个月。HFS 症状在第一个治疗周期后出现在 20%的患者中。HFS 的出现是无进展生存期延长的预测因素。事实上，HFS 组的无进展生存期超过了 60 个月的观察期，使得中位无进展生存期的计算变得不可能。这些发现再次证实了在接受 TKI 治疗期间监测皮肤毒性的重要性。我们得出结论，出现不良皮肤症状预示着接受舒尼替尼治疗的 mRCC 患者的预后更好。
