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The effect of sunitinib on primary renal cell carcinoma and facilitation of subsequent surgery.

PURPOSEWe investigated the effect of sunitinib on locally advanced primary renal carcinoma tumors and the ability to facilitate subsequent surgery. MATERIALS AND METHODSPatients with an unresectable primary renal tumor, with or without distant metastases, received 50 mg sunitinib with continuous dai... Full description

Journal Title: The Journal of urology May 2012, Vol.187(5), pp.1548-1554
Main Author: Rini, Brian I
Other Authors: Garcia, Jorge , Elson, Paul , Wood, Laura , Shah, Shetal , Stephenson, Andrew , Salem, Mohammed , Gong, Michael , Fergany, Amr , Rabets, John , Kaouk, Jihad , Krishnamurthi, Venkatesh , Klein, Eric , Dreicer, Robert , Campbell, Steven
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 1527-3792 ; DOI: 1527-3792 ; DOI: 10.1016/j.juro.2011.12.075
Link: http://search.proquest.com/docview/1000405130/?pq-origsite=primo
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title: The effect of sunitinib on primary renal cell carcinoma and facilitation of subsequent surgery.
format: Article
creator:
  • Rini, Brian I
  • Garcia, Jorge
  • Elson, Paul
  • Wood, Laura
  • Shah, Shetal
  • Stephenson, Andrew
  • Salem, Mohammed
  • Gong, Michael
  • Fergany, Amr
  • Rabets, John
  • Kaouk, Jihad
  • Krishnamurthi, Venkatesh
  • Klein, Eric
  • Dreicer, Robert
  • Campbell, Steven
subjects:
  • Adult–Therapeutic Use
  • Aged–Diagnostic Imaging
  • Aged, 80 and Over–Surgery
  • Antineoplastic Agents–Therapeutic Use
  • Carcinoma, Renal Cell–Diagnostic Imaging
  • Female–Surgery
  • Humans–Therapeutic Use
  • Indoles–Therapeutic Use
  • Kidney Neoplasms–Therapeutic Use
  • Male–Therapeutic Use
  • Middle Aged–Therapeutic Use
  • Neoadjuvant Therapy–Therapeutic Use
  • Nephrectomy–Therapeutic Use
  • Pyrroles–Therapeutic Use
  • Tomography, X-Ray Computed–Therapeutic Use
  • Abridged
  • Antineoplastic Agents
  • Indoles
  • Pyrroles
  • Sunitinib
ispartof: The Journal of urology, May 2012, Vol.187(5), pp.1548-1554
description: PURPOSEWe investigated the effect of sunitinib on locally advanced primary renal carcinoma tumors and the ability to facilitate subsequent surgery. MATERIALS AND METHODSPatients with an unresectable primary renal tumor, with or without distant metastases, received 50 mg sunitinib with continuous daily dosing in a phase II trial. Computerized tomography was performed every 12 weeks to determine surgical resectability. The primary end point of the trial was the percentage of patients with renal cell carcinoma and initially unresectable primary tumors who could undergo nephrectomy after sunitinib therapy. RESULTSOf 30 patients enrolled in the study (19 with distant metastases) 28 (35 total renal tumors) were evaluable for response. The median change in primary renal cell carcinoma tumors was a 22% decrease, corresponding to a median absolute reduction of 1.2 cm. The median reduction in primary renal cell carcinoma tumors of clear cell histology was -28% (absolute reduction 1.7 cm) compared to a 1.4% increase (0.1 cm absolute increase) in nonclear cell tumors. Of these patients 13 (45%) met the primary end point of being able to undergo nephrectomy after preoperative sunitinib. All patients had viable renal cell carcinoma in the surgical specimen and surgical morbidity was consistent with prior experience of nephrectomy in patients without preoperative therapy. CONCLUSIONSSunitinib as initial therapy in patients with locally advanced features of the primary tumor was feasible and resulted in an antitumor effect that enabled subsequent surgery in a subset of patients. Further prospective study is required to refine the most suitable application of this approach.
language: eng
source:
identifier: E-ISSN: 1527-3792 ; DOI: 1527-3792 ; DOI: 10.1016/j.juro.2011.12.075
fulltext: fulltext
issn:
  • 15273792
  • 1527-3792
url: Link


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titleThe effect of sunitinib on primary renal cell carcinoma and facilitation of subsequent surgery.
creatorRini, Brian I ; Garcia, Jorge ; Elson, Paul ; Wood, Laura ; Shah, Shetal ; Stephenson, Andrew ; Salem, Mohammed ; Gong, Michael ; Fergany, Amr ; Rabets, John ; Kaouk, Jihad ; Krishnamurthi, Venkatesh ; Klein, Eric ; Dreicer, Robert ; Campbell, Steven
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ispartofThe Journal of urology, May 2012, Vol.187(5), pp.1548-1554
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subjectAdult–Therapeutic Use ; Aged–Diagnostic Imaging ; Aged, 80 and Over–Surgery ; Antineoplastic Agents–Therapeutic Use ; Carcinoma, Renal Cell–Diagnostic Imaging ; Female–Surgery ; Humans–Therapeutic Use ; Indoles–Therapeutic Use ; Kidney Neoplasms–Therapeutic Use ; Male–Therapeutic Use ; Middle Aged–Therapeutic Use ; Neoadjuvant Therapy–Therapeutic Use ; Nephrectomy–Therapeutic Use ; Pyrroles–Therapeutic Use ; Tomography, X-Ray Computed–Therapeutic Use ; Abridged ; Antineoplastic Agents ; Indoles ; Pyrroles ; Sunitinib
descriptionPURPOSEWe investigated the effect of sunitinib on locally advanced primary renal carcinoma tumors and the ability to facilitate subsequent surgery. MATERIALS AND METHODSPatients with an unresectable primary renal tumor, with or without distant metastases, received 50 mg sunitinib with continuous daily dosing in a phase II trial. Computerized tomography was performed every 12 weeks to determine surgical resectability. The primary end point of the trial was the percentage of patients with renal cell carcinoma and initially unresectable primary tumors who could undergo nephrectomy after sunitinib therapy. RESULTSOf 30 patients enrolled in the study (19 with distant metastases) 28 (35 total renal tumors) were evaluable for response. The median change in primary renal cell carcinoma tumors was a 22% decrease, corresponding to a median absolute reduction of 1.2 cm. The median reduction in primary renal cell carcinoma tumors of clear cell histology was -28% (absolute reduction 1.7 cm) compared to a 1.4% increase (0.1 cm absolute increase) in nonclear cell tumors. Of these patients 13 (45%) met the primary end point of being able to undergo nephrectomy after preoperative sunitinib. All patients had viable renal cell carcinoma in the surgical specimen and surgical morbidity was consistent with prior experience of nephrectomy in patients without preoperative therapy. CONCLUSIONSSunitinib as initial therapy in patients with locally advanced features of the primary tumor was feasible and resulted in an antitumor effect that enabled subsequent surgery in a subset of patients. Further prospective study is required to refine the most suitable application of this approach.
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titleThe effect of sunitinib on primary renal cell carcinoma and facilitation of subsequent surgery.
descriptionPURPOSEWe investigated the effect of sunitinib on locally advanced primary renal carcinoma tumors and the ability to facilitate subsequent surgery. MATERIALS AND METHODSPatients with an unresectable primary renal tumor, with or without distant metastases, received 50 mg sunitinib with continuous daily dosing in a phase II trial. Computerized tomography was performed every 12 weeks to determine surgical resectability. The primary end point of the trial was the percentage of patients with renal cell carcinoma and initially unresectable primary tumors who could undergo nephrectomy after sunitinib therapy. RESULTSOf 30 patients enrolled in the study (19 with distant metastases) 28 (35 total renal tumors) were evaluable for response. The median change in primary renal cell carcinoma tumors was a 22% decrease, corresponding to a median absolute reduction of 1.2 cm. The median reduction in primary renal cell carcinoma tumors of clear cell histology was -28% (absolute reduction 1.7 cm) compared to a 1.4% increase (0.1 cm absolute increase) in nonclear cell tumors. Of these patients 13 (45%) met the primary end point of being able to undergo nephrectomy after preoperative sunitinib. All patients had viable renal cell carcinoma in the surgical specimen and surgical morbidity was consistent with prior experience of nephrectomy in patients without preoperative therapy. CONCLUSIONSSunitinib as initial therapy in patients with locally advanced features of the primary tumor was feasible and resulted in an antitumor effect that enabled subsequent surgery in a subset of patients. Further prospective study is required to refine the most suitable application of this approach.
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titleThe effect of sunitinib on primary renal cell carcinoma and facilitation of subsequent surgery.
authorRini, Brian I ; Garcia, Jorge ; Elson, Paul ; Wood, Laura ; Shah, Shetal ; Stephenson, Andrew ; Salem, Mohammed ; Gong, Michael ; Fergany, Amr ; Rabets, John ; Kaouk, Jihad ; Krishnamurthi, Venkatesh ; Klein, Eric ; Dreicer, Robert ; Campbell, Steven
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abstractPURPOSEWe investigated the effect of sunitinib on locally advanced primary renal carcinoma tumors and the ability to facilitate subsequent surgery. MATERIALS AND METHODSPatients with an unresectable primary renal tumor, with or without distant metastases, received 50 mg sunitinib with continuous daily dosing in a phase II trial. Computerized tomography was performed every 12 weeks to determine surgical resectability. The primary end point of the trial was the percentage of patients with renal cell carcinoma and initially unresectable primary tumors who could undergo nephrectomy after sunitinib therapy. RESULTSOf 30 patients enrolled in the study (19 with distant metastases) 28 (35 total renal tumors) were evaluable for response. The median change in primary renal cell carcinoma tumors was a 22% decrease, corresponding to a median absolute reduction of 1.2 cm. The median reduction in primary renal cell carcinoma tumors of clear cell histology was -28% (absolute reduction 1.7 cm) compared to a 1.4% increase (0.1 cm absolute increase) in nonclear cell tumors. Of these patients 13 (45%) met the primary end point of being able to undergo nephrectomy after preoperative sunitinib. All patients had viable renal cell carcinoma in the surgical specimen and surgical morbidity was consistent with prior experience of nephrectomy in patients without preoperative therapy. CONCLUSIONSSunitinib as initial therapy in patients with locally advanced features of the primary tumor was feasible and resulted in an antitumor effect that enabled subsequent surgery in a subset of patients. Further prospective study is required to refine the most suitable application of this approach.
doi10.1016/j.juro.2011.12.075
urlhttp://search.proquest.com/docview/1000405130/
issn00225347
date2012-05