Park Jee Soo, Koo Kyo Chul, Chung Doo Yong, Kim Sun Il, Kim Jeongho, Oh Cheol Kyu, Kim Tae Nam, Kang Sung Ku, Park Jae Won, Yoon Young Eun, Park Sung Yul, Rha Koon Ho, Ham Won Sik
Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea.
Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea.
Cancers (Basel). 2020 Dec 2;12(12):3602. doi: 10.3390/cancers12123602.
Sunitinib is a first-line treatment for metastatic renal cell carcinoma (mRCC). Little is known about the predictive factors of sunitinib-induced dose-limiting toxicity (DLT) in Asian populations. We investigated whether body composition predicts sunitinib-induced DLT. We retrospectively reviewed sunitinib-treated Korean patients with clear cell mRCC from eight institutions. Body composition was measured using computed tomography. DLT was defined as any adverse event leading to dose reduction or treatment discontinuation. Univariate analysis was used to compare body composition indices, and logistic regression analyses were performed for factors predicting early DLT. Overall, 111/311 (32.5%) of patients experienced DLT. Significant differences were observed in the subcutaneous adipose tissue index (SATI; = 0.001) and visceral adipose tissue index (VATI; < 0.001) between patients with and without DLT. Multivariate analyses revealed that VATI (odds ratio: 1.013; = 0.029) was significantly associated with early DLT. Additionally, 20% of patients who had a body mass index (BMI) greater than 23 kg/m and a low VATI experienced DLT, whereas 34.3% of the remaining groups had DLT ( = 0.034). Significant differences were observed for median progression-free survival (13.0 vs. 26.0 months, respectively; = 0.006) between patients with low and high VATI. Visceral adiposity was a significant predictor of sunitinib-associated DLT and survival. Patients with a low VATI and a BMI greater than 23 kg/m experienced lower DLTs.
舒尼替尼是转移性肾细胞癌（mRCC）的一线治疗药物。关于亚洲人群中舒尼替尼诱导的剂量限制性毒性（DLT）的预测因素知之甚少。我们研究了身体成分是否能预测舒尼替尼诱导的DLT。我们回顾性分析了来自8家机构接受舒尼替尼治疗的韩国透明细胞mRCC患者。使用计算机断层扫描测量身体成分。DLT定义为导致剂量减少或治疗中断的任何不良事件。采用单因素分析比较身体成分指标，并对预测早期DLT的因素进行逻辑回归分析。总体而言，111/311（32.5%）的患者出现DLT。有DLT和无DLT的患者在皮下脂肪组织指数（SATI； = 0.001）和内脏脂肪组织指数（VATI； < 0.001）方面存在显著差异。多因素分析显示，VATI（比值比：1.013； = 0.029）与早期DLT显著相关。此外，体重指数（BMI）大于23 kg/m且VATI较低的患者中有20%出现DLT，而其余组中有34.3%出现DLT（ = 0.034）。VATI低和高的患者在无进展生存期的中位数方面存在显著差异（分别为13.0个月和26.0个月； = 0.006）。内脏肥胖是舒尼替尼相关DLT和生存的重要预测因素。VATI低且BMI大于23 kg/m的患者DLT发生率较低。
