PMID- 32211333
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 10
DP  - 2020
TI  - A 2/1 Sunitinib Dosing Schedule Provides Superior Antitumor Effectiveness and 
      Less Toxicity Than a 4/2 Schedule for Metastatic Renal Cell Carcinoma: A 
      Systematic Review and Meta-Analysis.
PG  - 313
LID - 10.3389/fonc.2020.00313 [doi]
LID - 313
AB  - Background: The standard sunitinib schedule to treat metastatic renal cell 
      carcinoma (mRCC) is 4 weeks on/2 weeks off (4/2). However, some studies revealed 
      intolerable adverse events (AEs) in patients on this schedule. An alternative 
      schedule, 2 weeks on/1 week off (2/1), may overcome this issue. This 
      meta-analysis was performed to compare the effectiveness and toxicity between the 
      2/1 and 4/2 sunitinib dosing schedules. Methods: We acquired relevant studies by 
      searching PubMed, ScienceDirect, the Cochrane Library, Scopus, Ovid MEDLINE, 
      Embase, Web of Science, and Google Scholar. Our main endpoints included overall 
      survival (OS), progression-free survival (PFS), objective response rate (ORR), 
      disease control rate (DCR), and AEs. Results: We identified 9 medium- and 
      high-quality studies. Both schedules were effective for mRCC, with comparable OS 
      and similar ORR. However, the 2/1 schedule had better PFS (hazard ratio (HR) = 
      0.81, 95% confidence interval [CI]: 0.66-0.99, P = 0.04), higher DCR [risk rate 
      (RR) = 1.22, 95% CI: 1.01-1.47, P = 0.04] and fewer dosage interruptions (RR = 
      0.60, 95% CI: 0.43-0.84, P = 0.003). Additionally, the 2/1 schedule elicited 
      fewer specific severe AEs, including thrombocytopenia/platelet disorder, 
      hand-foot syndrome, hypertension, and fatigue. In our subanalysis, PFS was better 
      among East Asians using the 2/1 schedule than among other populations (HR= 0.75, 
      95% CI: 0.58-0.98, P = 0.03), and patients administered an initial dosage of 50 
      mg/d on the 2/1 schedule had superior PFS (HR = 0.76, 95% CI: 0.59-0.97, P = 
      0.03) than those others. Conclusions: These findings suggest that the 2/1 
      schedule is more suitable for mRCC than 4/2, due to superior PFS, better DCR and 
      fewer AEs. Nevertheless, more large-scale studies with good quality are needed.
CI  - Copyright (c) 2020 Deng, Li, Wu, Wang, Hong, Yi, Wei and Zhang.
FAU - Deng, Huan
AU  - Deng H
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Li, Meng
AU  - Li M
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Wu, Qian
AU  - Wu Q
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Wang, Li
AU  - Wang L
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Hong, Zhengdong
AU  - Hong Z
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Yi, Fengming
AU  - Yi F
AD  - Department of Oncology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Wei, Yiping
AU  - Wei Y
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
FAU - Zhang, Wenxiong
AU  - Zhang W
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
LA  - eng
PT  - Systematic Review
DEP - 20200306
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC7069552
OTO - NOTNLM
OT  - alternative dosing
OT  - effectiveness
OT  - meta-analysis
OT  - renal cell carcinoma
OT  - sunitinib
EDAT- 2020/03/27 06:00
MHDA- 2020/03/27 06:01
PMCR- 2020/01/01
CRDT- 2020/03/27 06:00
PHST- 2019/11/13 00:00 [received]
PHST- 2020/02/21 00:00 [accepted]
PHST- 2020/03/27 06:00 [entrez]
PHST- 2020/03/27 06:00 [pubmed]
PHST- 2020/03/27 06:01 [medline]
PHST- 2020/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2020.00313 [doi]
PST - epublish
SO  - Front Oncol. 2020 Mar 6;10:313. doi: 10.3389/fonc.2020.00313. eCollection 2020.