PMID- 31766332
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 11
IP  - 12
DP  - 2019 Nov 21
TI  - Does an Alternative Sunitinib Dosing Schedule Really Improve Survival Outcomes 
      over a Conventional Dosing Schedule in Patients with Metastatic Renal Cell 
      Carcinoma? An Updated Systematic Review and Meta-Analysis.
LID - 10.3390/cancers11121830 [doi]
LID - 1830
AB  - Treatment-related adverse events (AEs) can obfuscate the maintenance of a 
      conventional schedule of sunitinib in patients with metastatic renal cell 
      carcinoma. Accordingly, alternative schedules seeking to improve the safety 
      profile of sunitinib have been tested. Recently, two meta-analyses similarly 
      described improved safety profiles favoring a two weeks on and one week off (2/1) 
      schedule, but with conflicting results for survival outcomes. Therefore, we 
      conducted an updated systematic review and meta-analysis, including all recently 
      published studies and using complementary statistical methods. Endpoints included 
      progression-free survival, overall survival, and AEs of 15 types. Eleven articles 
      were included in this meta-analysis. Using adjusted findings, we noted 
      statistically better results in progression-free survival (hazard ratio, 0.58; 
      95% confidence interval, 0.39-0.84; p = 0.005), but no difference in overall 
      survival (hazard ratio, 0.66; 95% confidence interval, 0.42-1.04; p = 0.08). 
      Moreover, the 2/1 schedule was beneficial for reducing the incidence of several 
      AEs. Conclusively, our meta-analysis suggests that the 2/1 schedule holds promise 
      as an alternative means of reducing AEs and maintaining patient quality of life. 
      While the survival outcomes of the 2/1 schedule seem also to be favorable, the 
      level of evidence for this was low, and the interpretation of these findings 
      should warrant caution. Large scale randomized trials are needed to support these 
      results.
FAU - Chung, Doo Yong
AU  - Chung DY
AD  - Department of Urology, Inha University School of Medicine, Incheon 22212, Korea.
AD  - Department of Urology, Urological Science Institute, Yonsei University College of 
      Medicine, Seoul 06273, Korea.
FAU - Kang, Dong Hyuk
AU  - Kang DH
AD  - Department of Urology, Inha University School of Medicine, Incheon 22212, Korea.
FAU - Kim, Jong Won
AU  - Kim JW
AD  - Department of Urology, Gangnam Severance Hospital, Yonsei University College of 
      Medicine, Seoul 06273, Korea.
FAU - Kim, Do Kyung
AU  - Kim DK
AD  - Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang 
      University Medical College, Seoul 06273, Korea.
FAU - Lee, Joo Yong
AU  - Lee JY
AD  - Department of Urology, Severance Hospital, Yonsei University College of Medicine, 
      Seoul 06273, Korea.
FAU - Hong, Chang Hee
AU  - Hong CH
AD  - Department of Urology, Gangnam Severance Hospital, Yonsei University College of 
      Medicine, Seoul 06273, Korea.
FAU - Cho, Kang Su
AU  - Cho KS
AD  - Department of Urology, Gangnam Severance Hospital, Yonsei University College of 
      Medicine, Seoul 06273, Korea.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20191121
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC6966535
OTO - NOTNLM
OT  - adverse events
OT  - alternative dosing
OT  - meta-analysis
OT  - renal cell carcinoma
OT  - sunitinib
OT  - survival outcomes
OT  - systematic review
COIS- The authors declare no conflict of interest.
EDAT- 2019/11/27 06:00
MHDA- 2019/11/27 06:01
PMCR- 2019/11/21
CRDT- 2019/11/27 06:00
PHST- 2019/10/01 00:00 [received]
PHST- 2019/11/15 00:00 [revised]
PHST- 2019/11/18 00:00 [accepted]
PHST- 2019/11/27 06:00 [entrez]
PHST- 2019/11/27 06:00 [pubmed]
PHST- 2019/11/27 06:01 [medline]
PHST- 2019/11/21 00:00 [pmc-release]
AID - cancers11121830 [pii]
AID - cancers-11-01830 [pii]
AID - 10.3390/cancers11121830 [doi]
PST - epublish
SO  - Cancers (Basel). 2019 Nov 21;11(12):1830. doi: 10.3390/cancers11121830.