Korean J Urol.  2014 Jan;55(1):74-76. 10.4111/kju.2014.55.1.74.

Intolerance to Sunitinib Treatment in Hemodialysis Patients With Metastatic Renal Cell Carcinoma

Affiliations
  • 1Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey. dr_ibrahim2000@yahoo.com

Abstract

Sunitinib is a multiple tyrosine kinase receptor inhibitor that is approved for the treatment of metastatic renal cell carcinoma (RCC). However, neither an appropriate dose nor dosing schedule of sunitinib has yet been established for patients with metastatic RCC who are on hemodialysis. Here, we report on two hemodialysis patients who received sunitinib to treat metastatic RCC. Sunitinib was planned to be administered at a dosage of 25 mg/d for 4 of every 6 weeks. Although sunitinib toxicity was manageable in one patient, disease progression occurred after 4 months of treatment. In the second patient, acute pulmonary edema, caused by uncontrolled hypertension, developed on the 15th day of sunitinib therapy and the drug had to be discontinued. Sunitinib is thus not well tolerated in a hemodialysis setting. Close monitoring of toxicity and dose manipulation may be required if such therapy is attempted.

Keyword

Renal cell carcinoma; Renal dialysis; Sunitinib

MeSH Terms

Appointments and Schedules
Carcinoma, Renal Cell*
Disease Progression
Humans
Hypertension
Protein-Tyrosine Kinases
Pulmonary Edema
Renal Dialysis*
Protein-Tyrosine Kinases

Reference

1. Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Rixe O, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007; 356:115–124.
2. Zastrow S, Froehner M, Platzek I, Novotny V, Wirth MP. Treatment of metastatic renal cell cancer with sunitinib during chronic hemodialysis. Urology. 2009; 73:868–870.
3. Hong MH, Kim HS, Kim C, Ahn JR, Chon HJ, Shin SJ, et al. Treatment outcomes of sunitinib treatment in advanced renal cell carcinoma patients: a single cancer center experience in Korea. Cancer Res Treat. 2009; 41:67–72.
4. Reckova M, Kakalejcik M, Beniak J. Treatment of hemodialyzed patient with sunitinib. Ann Oncol. 2009; 20:392–393.
5. Yoon SH, Kim KH, Choi J, Kim GM, Kim JH, Kim HS, et al. Novel sunitinib strategy in metastatic renal cell carcinoma on hemodialysis: intermittent dose of sunitinib after hemodialysis. Cancer Res Treat. 2010; 42:180–184.
6. Roskoski R Jr. Sunitinib: a VEGF and PDGF receptor protein kinase and angiogenesis inhibitor. Biochem Biophys Res Commun. 2007; 356:323–328.
7. Faivre S, Delbaldo C, Vera K, Robert C, Lozahic S, Lassau N, et al. Safety, pharmacokinetic, and antitumor activity of SU11248, a novel oral multitarget tyrosine kinase inhibitor, in patients with cancer. J Clin Oncol. 2006; 24:25–35.
8. Izzedine H, Etienne-Grimaldi MC, Renee N, Vignot S, Milano G. Pharmacokinetics of sunitinib in hemodialysis. Ann Oncol. 2009; 20:190–192.
9. Agarwal R, Nissenson AR, Batlle D, Coyne DW, Trout JR, Warnock DG. Prevalence, treatment, and control of hypertension in chronic hemodialysis patients in the United States. Am J Med. 2003; 115:291–297.
10. Telli ML, Witteles RM, Fisher GA, Srinivas S. Cardiotoxicity associated with the cancer therapeutic agent sunitinib malate. Ann Oncol. 2008; 19:1613–1618.
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