Sunitinib re-challenge in advanced renal-cell carcinoma

Despite offering significant clinical benefits in advanced renal-cell carcinoma (RCC), the effectiveness of targeted therapies eventually declines with the development of resistance. Defining optimal sequences of therapy is therefore the focus of much current research. There is also evidence that tr...

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Main Authors: Porta, C, Paglino, C, Grünwald, V
Format: Online
Language:English
Published: Nature Publishing Group 2014
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453836/
id pubmed-4453836
recordtype oai_dc
spelling pubmed-44538362015-09-09 Sunitinib re-challenge in advanced renal-cell carcinoma Porta, C Paglino, C Grünwald, V Minireview Despite offering significant clinical benefits in advanced renal-cell carcinoma (RCC), the effectiveness of targeted therapies eventually declines with the development of resistance. Defining optimal sequences of therapy is therefore the focus of much current research. There is also evidence that treatment ‘re-challenge' may be an effective strategy in some patients. We review evidence to evaluate whether sunitinib may have value as re-challenge therapy in patients who have progressed on prior targeted therapy with sunitinib and/or an alternative tyrosine kinase inhibitor or mammalian target of rapamycin inhibitor. Re-challenge with sunitinib appears to be of clinical benefit, thus representing a feasible therapeutic option for patients with advanced RCC who are refractory to other treatments and are able to receive further therapy. These observations support hypotheses that resistance to targeted agents is transient and can be at least partially reversed by re-introduction of the same agent after a treatment break. Median progression-free survival durations appear to be shorter and response rates lower on re-challenge than following initial treatment, although a wider interval between treatments appears to increase response to sunitinib re-challenge. Nature Publishing Group 2014-09-09 2014-05-06 /pmc/articles/PMC4453836/ /pubmed/24800947 http://dx.doi.org/10.1038/bjc.2014.214 Text en Copyright © 2014 Cancer Research UK http://creativecommons.org/licenses/by-nc-sa/3.0/ From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Porta, C
Paglino, C
Grünwald, V
spellingShingle Porta, C
Paglino, C
Grünwald, V
Sunitinib re-challenge in advanced renal-cell carcinoma
author_facet Porta, C
Paglino, C
Grünwald, V
author_sort Porta, C
title Sunitinib re-challenge in advanced renal-cell carcinoma
title_short Sunitinib re-challenge in advanced renal-cell carcinoma
title_full Sunitinib re-challenge in advanced renal-cell carcinoma
title_fullStr Sunitinib re-challenge in advanced renal-cell carcinoma
title_full_unstemmed Sunitinib re-challenge in advanced renal-cell carcinoma
title_sort sunitinib re-challenge in advanced renal-cell carcinoma
description Despite offering significant clinical benefits in advanced renal-cell carcinoma (RCC), the effectiveness of targeted therapies eventually declines with the development of resistance. Defining optimal sequences of therapy is therefore the focus of much current research. There is also evidence that treatment ‘re-challenge' may be an effective strategy in some patients. We review evidence to evaluate whether sunitinib may have value as re-challenge therapy in patients who have progressed on prior targeted therapy with sunitinib and/or an alternative tyrosine kinase inhibitor or mammalian target of rapamycin inhibitor. Re-challenge with sunitinib appears to be of clinical benefit, thus representing a feasible therapeutic option for patients with advanced RCC who are refractory to other treatments and are able to receive further therapy. These observations support hypotheses that resistance to targeted agents is transient and can be at least partially reversed by re-introduction of the same agent after a treatment break. Median progression-free survival durations appear to be shorter and response rates lower on re-challenge than following initial treatment, although a wider interval between treatments appears to increase response to sunitinib re-challenge.
publisher Nature Publishing Group
publishDate 2014
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453836/
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