Sebastian Nachbargauer, Andreas Bruchbacher, Harun Fajkovic, Mesut Remzi, Manuela Schmidinger
BACKGROUND: Sunitinib has been the standard of care for patients with metastatic renal cell carcinoma (mRCC). However, nearly all patients will eventually develop resistance. Before the introduction of novel agents, few treatment options remained after sunitinib failure. Sunitinib rechallenge is a strategy based on the presumption that resistance might be only temporary. The aim of this analysis was to evaluate the efficacy and safety of sunitinib rechallenge in patients with mRCC.
PATIENTS AND METHODS: Patients who had undergone sunitinib rechallenge (SU2) at the Medical University of Vienna from 2010 to 2017 were identified for the present retrospective study. The primary endpoint was the treatment duration with rechallenge (TD). The secondary endpoints included the treatment duration with upfront sunitinib (TD), progression-free survival (PFS and PFS), overall survival (OS and OS), the objective response rate in both settings (ORR and ORR), and toxicity.
RESULTS: A total of 31 patients were eligible. The median TD was 7.2 months, and the median TD was 17.8 months. The median OS and OS was 57.9 months and 14.7 months, respectively. The median PFS and PFS was 14.2 months and 5.6 months, respectively. The ORR and ORR was 34% and 16%, and another 48% and 42% achieved stable disease (SD), respectively. Fatigue and hypertension were the most common adverse events.
CONCLUSIONS: Sunitinib rechallenge appears to benefit patients in later treatment lines. With the abundance of novel treatment options available, this approach might appear less relevant. However, novel agents are not yet available everywhere. Thus, sunitinib rechallenge could be an additional strategy to improve the outcomes of patients with mRCC.
