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Clinical Pharmacy
CP-086 Effectiveness of the treatment for advanced or metastasic renal-cell carcinoma (mRCC) in real conditions
  1. J Barral Juez1,
  2. G Lizeaga Cundin1,
  3. MP Carmona Oyaga1,
  4. M Umerez Igartua1,
  5. A Lizardi Mutuaberria1,
  6. P Pascual Gonzalez1,
  7. A Asensio Bermejo1,
  8. G Lopez Arzoz1,
  9. MP Bachiller Cacho1,
  10. M Barral Juez2
  1. 1Donostia University Hospital, Pharmacy, San Sebastián, Spain
  2. 2Eindhoven Technical University, Chemical Engineering Department, Eindhoven, The Netherlands

Abstract

Background Oral chemotherapy against metastatic or advanced renal-cell carcinoma (mRCC) is currently benefiting from a wide range of possibilities.

Purpose To analyse the effectiveness of the actual therapy for the treatment of the mRCC in real conditions based on survival at one and two years and modifications in dosage or drug.

Materials and methods Retrospective evaluation of clinical history from November 2011 to September 2013.

In our hospital tyrosine kinase inhibitors were the first line treatment and mTOR inhibitors were the second line.

Results 68 patients were treated for mRCC. Male/Female: 73/27. Average age: 64.6 years.

After 1 year of treatment 81.4% patients survived (22/27) and 42.8% after two years (3/7).

44/68 patients (65%), needed a drug change due to progression. Average time to change was 6.4 months (59% CL: 4.6–8.1) (median: 5.1). 8/68 (11.7%) required a treatment change towards a third line. Of these 8 patients; 3 restarted treatment with sunitinib as fourth line.

Out of 41 patients who initiated therapy with sunitinib 50 mg once daily on schedule 4–2; 19 patients (46.3%) needed a descending adjustment of the dose. The average time to dose adjustment was 4.2 months (59% CL: 2.6–5.7)

Conclusions Oral treatment of advanced renal cancer has several therapeutic possibilities; which must be treated with rigorous criterion in favour of the clinical benefit applying the maximum efficiency.

Even limited by the small sample size, the results are similar to those previously reported in this setting.

First year survival rate: 81.4% vs. 75%1

Second year survival rate: 42.8% vs. 50%1

Of the 68 patients studied, 65% required a drug change during their treatment mostly due to loss of efficacy.

Sunitinib 50 mg 4–2 schedule dose adjustment: 46.3% vs. 46%2 (33% + 13%)

Time to dose adjustment: 4.2 months versus 7.5 months2

References

  1. RJ Motzer, B Escudier, R Bukowski, et al. Prognostic factors for survival in 1059 patients treated with sunitinib for metastatic renal cell carcinoma. British Journal of Cancer 2013;108:2470-2477

  2. Martin E Gore, Cezary Szczlik, Camillo Porta, et al. Safety and efficacy of sunitinib for metastatic renal-cell carcinoma: an expanded-access trial. Lancet Oncol 2009;10:757-63

No conflict of interest.

http://dx.doi.org/10.1136/ejhpharm-2013-000436.84

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