Metastatic Renal Cell Carcinoma: Sunitinib as First-Line Treatment; Results of a Retrospective Study

Abstract Background: Targeted agents were introduced over past years because of better understanding of oncogenetic mechanisms in metastatic renal cell carcinoma (mRCC). These agents include tyrosine kinase inhibitors (TKIs) such as sorafenib, sunitinib, pazopanib and axitinib. Methods: Review of recorded data from patients’ files with mRCC were analysed during the period from August 2008 to December 2014. Those patients were treated by sunitinib as first-line therapy. The data included patients characteristics such as age, sex, ECOG performance status (ECOG PS), number and sites of metastasis and pathological type. Also, we reviewed response to sunitinib therapy, its adverse events and progression-free survival (PFS). Results: This study included 26 patients; median age was 56 years with male predominance (76.9%) and 61.5% of patients were of ECOG PS0. Lymph nodes were the most common site of metastasis (38.5%) and 46.2% presented with ≥3 sites of disease. Clear cell pathology was reported in 96.2%. No grade IV adverse events to sunitinib reactions were observed. Thrombocytopenia was the most predominant haematological reaction (46%) followed by neutropenia (38.6%), whilst fatigue was the most reported non-haematological one (50%) followed by diarrhoea (42.3%). Partial response (PR) was found in 30.8% and stable disease (SD) in 46.2%. One-year PFS was 57.7% with median PFS time of 12 months. Conclusion: This study proved effectiveness and safety of sunitinib as first-line treatment for mRCC. However, this is a retrospective study and relatively small numbers of patients were included, so prospective studies with larger number of patients are needed for further evaluation.