Does sunitinib still have a place in the current recommendations for the systemic treatment of advanced renal cell carcinoma?

Renal cancer is a common malignancy. The frequency of renal cell carcinoma (RCC) in the structure of oncological diseases is steadily increasing. Despite the migration of the stage towards an increase in the frequency of primary detection of localized forms of the disease, renal cancer belongs to the aggressive and unpredictable malignant neoplasms. One third of patients already have distant metastases at the time of diagnosis. Surgery is the only radical method of treatment of renal cancer. However, despite the successes of surgery in the treatment of RCC, according to various data, more than 30% of radically operated patients show dissemination of the tumor process during follow-up. Radiation therapy and chemotherapy are ineffective in treating metastatic RCC (mRCC). The results of nonspecific immunotherapy in the treatment of metastatic renal cancer were also unsatisfactory. Progress in the study of molecular biology has led to the discovery of a new group of anti-tumor drugs related to angiogenesis inhibitors. The use of targeted therapies has increased the efficacy of drug therapy in the treatment of mRCC several times over the use of cytokine immunotherapy. One of the first such drugs registered in 2007 for the treatment of mRCC was sunitinib, which in a number of clinical trials has demonstrated the greatest efficacy and acceptable toxicity. Along with new drug regimens, the multikinase inhibitor sunitinib remains the drug of choice for first-line therapy of inoperable locally advanced and disseminated clear cell and non-small cell RCC in patients with favorable prognosis. The literature review presents a critical analysis of the data related to sunitinib research in kidney cancer and changes in the position of monotherapy with this drug in advanced forms of the disease.

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Candidate Gene and MicroRNA Biomarkers of Metastatic Renal Cell Carcinoma (MRCC) Response to Sunitinib

10.21203/rs.3.rs-1228653/v1 ◽

2022 ◽

Author(s):

qiwei yang ◽

wei yang ◽

yijun tian ◽

da xu ◽

chuanmin chu ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Differentially Expressed Genes ◽

Renal Cancer ◽

Metastatic Renal Cell Carcinoma ◽

Renal Cell ◽

Differentially Expressed ◽

Sphingolipid Metabolism ◽

Microrna Target ◽

Metastatic Renal Cancer

Abstract Backgrounds: The incidence of renal cancer is relatively insidious, and some patients have been metastatic renal cancer at the initial visit. Sunitinib is the first-line systemic therapy for patients with metastatic renal cell carcinoma, however, there is scant analysis of its effect on genes and microRNAs.Methods: In this study, 8 differentially expressed microRNAs and 112 differentially expressed genes were designated by analyzing mRNA and microRNA data sets and weighted correlation network analysis (WGCNA).Results: NIPSNAP1 gene showed the most co-expression with other genes. Through the intersection of the microRNA target gene with our differentially expressed genes, we got 26 genes. KEGG and GO analysis showed that these genes were predominantly concentrated in Pathways in cancer, Sphingolipid metabolism and Glycosaminoglycan degradation. After we set the 26 genes and gene of WGCNA do intersection, received six genes, respectively is NIPSNAP1, SDC4, TBC1D9, NEU1, STK40 and PLAUR. Conclusion: Through subsequent cell, molecular and flow cytometry experiments, we found the PLAUR would play a crucial role in renal cell carcinoma (RCC) resistant to sunitinib, which will be available for new ideas to forecast sunitinib resistance and reverse sunitinib resistance.

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Phase II study of interferon alfa-2a, recombinant (Roferon-A) in metastatic renal cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.1987.5.7.1083 ◽

1987 ◽

Vol 5 (7) ◽

pp. 1083-1089 ◽

Cited By ~ 43

Author(s):

A C Buzaid ◽

A Robertone ◽

C Kisala ◽

S E Salmon

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Metastatic Renal Cell Carcinoma ◽

Renal Cell ◽

Locally Advanced ◽

Interferon Alfa ◽

Induction Phase ◽

Optimal Dosage ◽

Metastatic Renal Cancer ◽

Recombinant Interferon

In an attempt to decrease toxicity without compromising efficacy, 22 patients with locally advanced or metastatic renal cell carcinoma (RCC) were treated with recombinant interferon alfa-2a (rIFN alpha 2a, Roferon-A; Hoffman-LaRoche, Nutley, NJ) intramuscularly (IM) beginning at a dose of 3 X 10(6) U/d with incremental dose escalations to the highest dose of 36 X 10(6) U/d if tolerated, for a total induction period of 10 weeks. Patients demonstrating complete (CR), partial (PR), or minor (MR) responses or stabilization were continued on a maintenance regimen of the highest tolerated dose administered three times weekly until disease progression. Doses administered during maintenance were individually determined as the maximum dose that resulted in only mild toxicity. No CRs were achieved. Partial responses were observed in 23% of the patients with a median duration of response of 8.0 months (range, 1 to 17+). The majority of interferon side effects were seen during the induction phase, which was also the period requiring the most frequent adjustments in dose. In comparison to another study using similar toxicity criteria, overall toxicity was reduced in severity, most probably due to the study design, which allowed individual tailoring of doses. The use of an initial induction phase employing rapid dose escalation followed by a well-tolerated maintenance phase appeared to be a reasonable strategy. The therapeutic results to date represent a modest advance. An optimal dosage, route, and schedule for interferon administration for metastatic renal cancer is not yet clearly established.

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Renal cell carcinoma metastasis in the bladder diagnosed based on transurethral resection after hematuria: a case report

MOJ Clinical & Medical Case Reports ◽

10.15406/mojcr.2020.10.00367 ◽

2020 ◽

Vol 10 (6) ◽

pp. 156-158

Author(s):

Lucas de Oliveira Lima

Keyword(s):

Computed Tomography ◽

Renal Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Renal Cancer ◽

Transurethral Resection ◽

Renal Cell ◽

Locally Advanced ◽

Renal Cell Carcinoma Metastasis ◽

Carcinoma Metastasis

Introduction: Despite the population's greater access to imaging tests and consequent diagnosis of renal cancer in early stages, we continue to encounter neoplasms in locally advanced and metastatic stages. Case report: We report a patient admitted to the emergency department of the Hospital Geral de Fortaleza with hematuria and urinary retention. After the patient underwent computed tomography and transurethral resection, a diagnosis of renal cell carcinoma metastasis in the bladder was confirmed based on immune histo chemistry results. Discussion: Metastasis of renal cell carcinoma in the bladder is rare, with few cases reported in the literature on synchronic presentation. Final considerations: Although rare, we must consider the possibility of metastasis of renal cell carcinoma in patients who present with hematuria, especially in those previously diagnosed with renal cancer.

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