Alternative sunitinib dosing regimens prolong survival in metastatic renal cell carcinoma

Alternative dosing regimens of sunitinib appear to be effective in improving survival outcomes of patients with metastatic renal cell carcinoma (MRCC), results of a study have shown.

“Standard dosing regimen of sunitinib for MRCC consists of 4 weeks treatment followed by 2 weeks rest (intermittent dosing),” the authors said. “Alternative regimens have been suggested, including continuous daily dosing and nonconventional dosing (eg, 2 weeks on/1 week off), to provide more individualized therapy with less toxicities.”

The study included 180 patients, most of which received intermittent dosing (n=120; 67 percent), followed by continuous dosing (n=32; 18 percent) and nonconventional dosing (n=28; 16 percent).

Continuous dosing, compared to intermittent dosing, was associated with comparable overall survival (median, 1 vs 13 months; hazard ratio [HR], 0.67; 95 percent confidence interval [CI], 0.43–1.06; p=0.088). On the other hand, nonconventional dosing correlated with significantly longer overall survival (median, 9 vs 23 months; HR, 0.55, 95 percent CI, 0.34–0.90; p=0.016).

Likewise, progression-free survival was significantly better for continuous dosing (median, 4 vs 9 months; HR, 0.61, 95 percent CI, 0.40–0.94; p=0.025) and for nonconventional dosing (median, 4 vs 10 months; HR, 0.61, 95 percent CI, 0.39–0.95; p=0.03) compared to intermittent dosing.

One in five patients discontinued sunitinib treatment due to adverse events. This finding was consistent with previous sunitinib trials.

In this study, MRCC patients treated with sunitinib between 1 July 2017 and 1 July 2011 were included. The authors retrospectively reviewed medical records and dispensing data to categorize sunitinib dosing as intermittent, continuous or nonconventional.