Use of sunitinib in patients with metastatic kidney cancer in real clinical practice

Over 200,000 new cases of renal-cell carcinoma (RCC) are notified worldwide every year. Examinations diagnose metastatic RCC (mRCC) in 25 % of primary patients; and after radical surgery 20–40 % of the patients are further diagnosed with disease progression and metastases. Randomized trials have demonstrated the efficacy of tyrosine kinase inhibitors in treating mRCC. Clinical trials are conducted on a carefully selected population of patients; the latter have generally clear-cell RCC without brain metastases and a good somatic status. In real clinical practice, the population of patients with mRCC is more heterogeneous; there are patients with non-clear cell mRCC, brain metastases, and an ECOG somatic status > 1; this raises the question as to whether it is effective and appropriate to use target agents in these patient groups.

The paper gives the data of performed clinical trials using sunitinib with expanded inclusion criteria and those of non-randomized trials that have proven the clinical efficacy of the drug in patients with a poor prognosis, non-clear cell mRCC, and brain metastases, as well as in the elderly. Despite lower objective response rates, the progression-free survival rates in this category of patients have proven to be comparable to those in patients with clear cell mRCC.