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Complete remission with sunitinib in a poor-risk patient with metastatic renal cell carcinoma: the fine balance between toxicity and efficacy.

Abstract
Sunitinib represents a reasonable therapeutic option for first-line treatment of poor-risk metastatic renal cell carcinoma and the treatment should aim at the delicate balance between managing side effects to improve the toxicity profile and patient compliance to treatment while maintaining anticancer efficacy. Achievement of a complete response, although rare, is possible, even in poor-risk patients. Treatment discontinuation represents a viable alternative for both tumour biology and patients' quality of life. To date, no molecular markers have been identified with prognostic and/or predictive value for guiding therapeutic decisions. Further research should aim at gaining in-depth knowledge of renal cell carcinoma biology for a tailored personalized therapy. We report a case of poor-risk metastatic renal cell carcinoma, with Von Hippel-Lindau loss of function, which achieved and maintained a complete remission after first-line therapy with sunitinib by using a reduced dosage and a modified schedule of treatment.
AuthorsFrancesco Massari, Chiara Ciccarese, Davide Bimbatti, Emanuela Fantinel, Alessandra Modena, Michele Simbolo, Matteo Brunelli, Walter Artibani, Guido Martignoni, Aldo Scarpa, Giampaolo Tortora
JournalAnti-cancer drugs (Anticancer Drugs) Vol. 26 Issue 4 Pg. 469-73 (Apr 2015) ISSN: 1473-5741 [Electronic] England
PMID25569703 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Angiogenesis Inhibitors
  • Indoles
  • Pyrroles
  • sunitinib
  • Protein-Tyrosine Kinases
  • VHL protein, human
  • Von Hippel-Lindau Tumor Suppressor Protein
Topics
  • Aged
  • Angiogenesis Inhibitors (administration & dosage, adverse effects)
  • Carcinoma, Renal Cell (drug therapy, genetics, secondary)
  • Female
  • Humans
  • Indoles (administration & dosage, adverse effects)
  • Kidney Neoplasms (drug therapy, genetics, pathology)
  • Mutation
  • Protein-Tyrosine Kinases (antagonists & inhibitors)
  • Pyrroles (administration & dosage, adverse effects)
  • Remission Induction
  • Risk
  • Von Hippel-Lindau Tumor Suppressor Protein (genetics)

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