PMID- 26774206
OWN - NLM
STAT- MEDLINE
DCOM- 20171016
LR  - 20181202
IS  - 1938-0682 (Electronic)
IS  - 1558-7673 (Linking)
VI  - 14
IP  - 4
DP  - 2016 Aug
TI  - Synergistic Survival: A New Phenomenon Connected to Adverse Events of First-Line 
      Sunitinib Treatment in Advanced Renal Cell Carcinoma.
PG  - 314-22
LID - S1558-7673(15)00315-8 [pii]
LID - 10.1016/j.clgc.2015.11.016 [doi]
AB  - BACKGROUND: The aim was to assess the relationship between treatment efficacy and 
      adverse events (AEs) for patients with advanced renal cell carcinoma treated with 
      first-line sunitinib. PATIENTS AND METHODS: 274 patients were treated with 
      sunitinib (50 mg/d, 4-weeks-on and 2-weeks-off schedule). Physical and laboratory 
      evaluations were done every sixth week. AEs were diagnosed at every visit. 
      Clinical response was assessed every 3 months. The objective response rate (ORR), 
      median progression-free (mPFS) and median overall survival (mOS) and AEs were 
      evaluated. Besides chi(2) and log rank tests, multivariate Cox regression analysis 
      and for synergism 1-sided t tests were used. RESULTS: The ORR was 25%. After a 
      median follow-up of 32 months, the mPFS and mOS were 9 and 19 months, 
      respectively. Hypertension, diarrhea, hypothyroidism, mucositis, hand-foot 
      syndrome (HFS), skin toxicity, and leukopenia were the most frequent 
      treatment-associated AEs. Significantly longer (P < .01) mPFS and mOS were 
      observed when hypertension, diarrhea, HFS, hypothyroidism, skin toxicity, or 
      leukopenia occurred. A statistically significant synergistic effect of the listed 
      AEs was observed for progression-free survival (P < .001) and overall survival 
      (P < .001). Multivariate analysis revealed that besides the prognostic category, 
      the higher number of AEs (3-6 vs. 0-2) was an independent marker of longer mPFS 
      (24 vs. 5 months, respectively; P < .001) and mOS (51 vs. 9 months, respectively; 
      P < .001). CONCLUSION: Results of this study provide evidence for the 
      synergistically enhanced efficacy of sunitinib treatment in patients who present 
      multiple AEs. These AEs are diagnosed routinely and their coexistence can help 
      physicians to predict which group of patients would benefit the most from 
      first-line sunitinib treatment.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Nagyivanyi, Krisztian
AU  - Nagyivanyi K
AD  - National Institute of Oncology, Budapest, Hungary.
FAU - Budai, Barna
AU  - Budai B
AD  - National Institute of Oncology, Budapest, Hungary. Electronic address: 
      budai@oncol.hu.
FAU - Biro, Krisztina
AU  - Biro K
AD  - National Institute of Oncology, Budapest, Hungary.
FAU - Gyergyay, Fruzsina
AU  - Gyergyay F
AD  - National Institute of Oncology, Budapest, Hungary.
FAU - Noszek, Laszlo
AU  - Noszek L
AD  - Semmelweis University, Budapest, Hungary.
FAU - Kuronya, Zsofia
AU  - Kuronya Z
AD  - National Institute of Oncology, Budapest, Hungary.
FAU - Nemeth, Hajnalka
AU  - Nemeth H
AD  - National Institute of Oncology, Budapest, Hungary.
FAU - Nagy, Peter
AU  - Nagy P
AD  - National Institute of Oncology, Budapest, Hungary.
FAU - Geczi, Lajos
AU  - Geczi L
AD  - National Institute of Oncology, Budapest, Hungary.
LA  - eng
PT  - Journal Article
DEP - 20151207
PL  - United States
TA  - Clin Genitourin Cancer
JT  - Clinical genitourinary cancer
JID - 101260955
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Indoles)
RN  - 0 (Pyrroles)
RN  - V99T50803M (Sunitinib)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/*administration & dosage/adverse effects
MH  - Carcinoma, Renal Cell/*drug therapy
MH  - Disease-Free Survival
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Humans
MH  - Indoles/*administration & dosage/adverse effects
MH  - Kaplan-Meier Estimate
MH  - Kidney Neoplasms/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Pyrroles/*administration & dosage/adverse effects
MH  - Sunitinib
MH  - Survival Analysis
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Advanced renal cell carcinoma
OT  - Adverse events
OT  - First-line sunitinib
OT  - Predictive marker
OT  - Synergistic survival
EDAT- 2016/01/18 06:00
MHDA- 2017/10/17 06:00
CRDT- 2016/01/18 06:00
PHST- 2015/09/30 00:00 [received]
PHST- 2015/11/30 00:00 [accepted]
PHST- 2016/01/18 06:00 [entrez]
PHST- 2016/01/18 06:00 [pubmed]
PHST- 2017/10/17 06:00 [medline]
AID - S1558-7673(15)00315-8 [pii]
AID - 10.1016/j.clgc.2015.11.016 [doi]
PST - ppublish
SO  - Clin Genitourin Cancer. 2016 Aug;14(4):314-22. doi: 10.1016/j.clgc.2015.11.016. 
      Epub 2015 Dec 7.