Document Detail


Sunitinib in metastatic renal cell carcinoma: recommendations for management of noncardiovascular toxicities.
MedLine Citation:
PMID:  21490127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The multitargeted tyrosine-kinase inhibitor sunitinib has emerged as one of the standards of care for good- and intermediate-risk metastatic renal cell carcinoma. Although generally associated with acceptable toxicity, sunitinib exhibits a novel and distinct toxicity profile that requires monitoring and management. Fatigue, diarrhea, anorexia, oral changes, hand-foot syndrome and other skin toxicity, thyroid dysfunction, myelotoxicity, and hypertension seem to be the most common and clinically relevant toxicities of sunitinib. Drug dosing and treatment duration are correlated with response to treatment and survival. Treatment recommendations for hypertension have been published but, currently, no standard guidelines exist for the management of noncardiovascular side effects. To discuss the optimal management of noncardiovascular side effects, an international, interdisciplinary panel of experts gathered in November 2009. Existing literature on incidence, severity, and underlying mechanisms of side effects as well as on potential treatment options were carefully reviewed and discussed. On the basis of these proceedings and the thorough review of the existing literature, recommendations were made for the monitoring, prevention, and treatment of the most common noncardiovascular side effects and are summarized in this review. The proactive assessment and consistent and timely management of sunitinib-related side effects are critical to ensure optimal treatment benefit by allowing appropriate drug dosing and prolonged treatment periods.
Authors:
Christian Kollmannsberger; Georg Bjarnason; Patrick Burnett; Patricia Creel; Mellar Davis; Nancy Dawson; Darren Feldman; Suzanne George; Jerome Hershman; Thomas Lechner; Amy Potter; Eric Raymond; Nathaniel Treister; Laura Wood; Shenhong Wu; Ronald Bukowski
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Publication Detail:
Type:  Journal Article; Review     Date:  2011-04-13
Journal Detail:
Title:  The oncologist     Volume:  16     ISSN:  1549-490X     ISO Abbreviation:  Oncologist     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-18     Completed Date:  2011-09-13     Revised Date:  2012-05-01    
Medline Journal Info:
Nlm Unique ID:  9607837     Medline TA:  Oncologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  543-53     Citation Subset:  IM    
Affiliation:
Division of Medical Oncology, BCCA Vancouver Cancer Centre, University of British Columbia, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada. ckollmannsberger@bccancer.bc.ca
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MeSH Terms
Descriptor/Qualifier:
Asthenia / chemically induced,  therapy
Carcinoma, Renal Cell / drug therapy*,  secondary
Diarrhea / chemically induced,  therapy
Dose-Response Relationship, Drug
Erythema / chemically induced,  therapy
Exanthema / chemically induced,  therapy
Fatigue / chemically induced,  therapy
Humans
Hypothyroidism / chemically induced,  therapy
Indoles / administration & dosage,  adverse effects*,  therapeutic use
Kidney Neoplasms / drug therapy*,  pathology
Practice Guidelines as Topic*
Protein Kinase Inhibitors / administration & dosage,  adverse effects*,  therapeutic use
Pyrroles / administration & dosage,  adverse effects*,  therapeutic use
Standard of Care
Chemical
Reg. No./Substance:
0/Indoles; 0/Protein Kinase Inhibitors; 0/Pyrroles; 0/sunitinib

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