Real-world experience of the feasibility and tolerability of the 2/1 dosing schedule with sunitinib in the treatment of patients with advanced renal cell carcinoma in Australia

Megan Crumbaker, Alexander Guminski, Howard Gurney, Dhanusha Sabanathan, Shirley Wong, Nick Pavlakis

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: Sunitinib is a first-line treatment option for metastatic renal cell carcinoma (mRCC) funded by the Australian Pharmaceutical Benefits Scheme. Toxicities are common with the standard schedule leading to alternative dosing schedules to be suggested. We reviewed Australian treatment practices to evaluate the safety and outcomes of patients on a 2 weeks on, 1 week off treatment schedule (2/1). Methods: We performed a retrospective review of 63 patients with mRCC treated with first-line sunitinib on a 2/1 schedule at four Australian centers. Results: Forty-six patients (73%) initiated sunitinib on the 2/1 schedule whereas 17 (27%) switched from the 4/2 schedule due to toxicity. Three progressing on a 4/2 schedule tolerated up-titration of their dose with a clinical and radiological response on the 2/1 schedule. The median duration of treatment was 31.9 months; median duration of treatment on the 2/1 schedule in patients changing from 4/2 was 11.5 months. Few (6.3%) ceased due to toxicity. Median overall survival was 37.2 months. Conclusion: In this retrospective review of the 2/1 sunitinib schedule, time on treatment with clinical benefit exceeded the overall survival times seen in the phase III trials utilizing the 4/2 schedule. Overall survival also exceeded that seen in these trials. Few patients ceased due to toxicity. The 2/1 schedule appears to be an acceptable schedule to use in selected patients with mRCC both at initiation of first-line treatment and in those intolerant to the 4/2 schedule.

LanguageEnglish
Pagese45-e49
Number of pages5
JournalAsia-Pacific Journal of Clinical Oncology
Volume14
Issue number2
DOIs
Publication statusPublished - Apr 2018
Externally publishedYes

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Renal Cell Carcinoma
Appointments and Schedules
Therapeutics
sunitinib
Survival
Patient Safety

Keywords

  • Renal cell carcinoma
  • Schedule
  • Sunitinib
  • Toxicity

Cite this

@article{e59881d036174cc2aa2029cfd7723042,
title = "Real-world experience of the feasibility and tolerability of the 2/1 dosing schedule with sunitinib in the treatment of patients with advanced renal cell carcinoma in Australia",
abstract = "Aim: Sunitinib is a first-line treatment option for metastatic renal cell carcinoma (mRCC) funded by the Australian Pharmaceutical Benefits Scheme. Toxicities are common with the standard schedule leading to alternative dosing schedules to be suggested. We reviewed Australian treatment practices to evaluate the safety and outcomes of patients on a 2 weeks on, 1 week off treatment schedule (2/1). Methods: We performed a retrospective review of 63 patients with mRCC treated with first-line sunitinib on a 2/1 schedule at four Australian centers. Results: Forty-six patients (73{\%}) initiated sunitinib on the 2/1 schedule whereas 17 (27{\%}) switched from the 4/2 schedule due to toxicity. Three progressing on a 4/2 schedule tolerated up-titration of their dose with a clinical and radiological response on the 2/1 schedule. The median duration of treatment was 31.9 months; median duration of treatment on the 2/1 schedule in patients changing from 4/2 was 11.5 months. Few (6.3{\%}) ceased due to toxicity. Median overall survival was 37.2 months. Conclusion: In this retrospective review of the 2/1 sunitinib schedule, time on treatment with clinical benefit exceeded the overall survival times seen in the phase III trials utilizing the 4/2 schedule. Overall survival also exceeded that seen in these trials. Few patients ceased due to toxicity. The 2/1 schedule appears to be an acceptable schedule to use in selected patients with mRCC both at initiation of first-line treatment and in those intolerant to the 4/2 schedule.",
keywords = "Renal cell carcinoma, Schedule, Sunitinib, Toxicity",
author = "Megan Crumbaker and Alexander Guminski and Howard Gurney and Dhanusha Sabanathan and Shirley Wong and Nick Pavlakis",
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Real-world experience of the feasibility and tolerability of the 2/1 dosing schedule with sunitinib in the treatment of patients with advanced renal cell carcinoma in Australia. / Crumbaker, Megan; Guminski, Alexander; Gurney, Howard; Sabanathan, Dhanusha; Wong, Shirley; Pavlakis, Nick.

In: Asia-Pacific Journal of Clinical Oncology, Vol. 14, No. 2, 04.2018, p. e45-e49.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Real-world experience of the feasibility and tolerability of the 2/1 dosing schedule with sunitinib in the treatment of patients with advanced renal cell carcinoma in Australia

AU - Crumbaker, Megan

AU - Guminski, Alexander

AU - Gurney, Howard

AU - Sabanathan, Dhanusha

AU - Wong, Shirley

AU - Pavlakis, Nick

PY - 2018/4

Y1 - 2018/4

N2 - Aim: Sunitinib is a first-line treatment option for metastatic renal cell carcinoma (mRCC) funded by the Australian Pharmaceutical Benefits Scheme. Toxicities are common with the standard schedule leading to alternative dosing schedules to be suggested. We reviewed Australian treatment practices to evaluate the safety and outcomes of patients on a 2 weeks on, 1 week off treatment schedule (2/1). Methods: We performed a retrospective review of 63 patients with mRCC treated with first-line sunitinib on a 2/1 schedule at four Australian centers. Results: Forty-six patients (73%) initiated sunitinib on the 2/1 schedule whereas 17 (27%) switched from the 4/2 schedule due to toxicity. Three progressing on a 4/2 schedule tolerated up-titration of their dose with a clinical and radiological response on the 2/1 schedule. The median duration of treatment was 31.9 months; median duration of treatment on the 2/1 schedule in patients changing from 4/2 was 11.5 months. Few (6.3%) ceased due to toxicity. Median overall survival was 37.2 months. Conclusion: In this retrospective review of the 2/1 sunitinib schedule, time on treatment with clinical benefit exceeded the overall survival times seen in the phase III trials utilizing the 4/2 schedule. Overall survival also exceeded that seen in these trials. Few patients ceased due to toxicity. The 2/1 schedule appears to be an acceptable schedule to use in selected patients with mRCC both at initiation of first-line treatment and in those intolerant to the 4/2 schedule.

AB - Aim: Sunitinib is a first-line treatment option for metastatic renal cell carcinoma (mRCC) funded by the Australian Pharmaceutical Benefits Scheme. Toxicities are common with the standard schedule leading to alternative dosing schedules to be suggested. We reviewed Australian treatment practices to evaluate the safety and outcomes of patients on a 2 weeks on, 1 week off treatment schedule (2/1). Methods: We performed a retrospective review of 63 patients with mRCC treated with first-line sunitinib on a 2/1 schedule at four Australian centers. Results: Forty-six patients (73%) initiated sunitinib on the 2/1 schedule whereas 17 (27%) switched from the 4/2 schedule due to toxicity. Three progressing on a 4/2 schedule tolerated up-titration of their dose with a clinical and radiological response on the 2/1 schedule. The median duration of treatment was 31.9 months; median duration of treatment on the 2/1 schedule in patients changing from 4/2 was 11.5 months. Few (6.3%) ceased due to toxicity. Median overall survival was 37.2 months. Conclusion: In this retrospective review of the 2/1 sunitinib schedule, time on treatment with clinical benefit exceeded the overall survival times seen in the phase III trials utilizing the 4/2 schedule. Overall survival also exceeded that seen in these trials. Few patients ceased due to toxicity. The 2/1 schedule appears to be an acceptable schedule to use in selected patients with mRCC both at initiation of first-line treatment and in those intolerant to the 4/2 schedule.

KW - Renal cell carcinoma

KW - Schedule

KW - Sunitinib

KW - Toxicity

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DO - 10.1111/ajco.12686

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VL - 14

SP - e45-e49

JO - Asia-Pacific Journal of Clinical Oncology

T2 - Asia-Pacific Journal of Clinical Oncology

JF - Asia-Pacific Journal of Clinical Oncology

SN - 1743-7555

IS - 2

ER -