The efficacy and safety of irinotecan cisplatin and mitomycin chemotherapy in sunitinib pre-treated metastatic clear cell renal cancer

Original Research

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Authors: Thomas Powles, Siobhan McFaul, Justin Stebbing, Peter Wilson, Tim Oliver et al

Published Date September 2008 Volume 2008:1 Pages 35 - 39

DOI: http://dx.doi.org/10.2147/OTT.S3590

Thomas Powles, Siobhan McFaul, Justin Stebbing, Peter Wilson, Tim Oliver, Naomi Tranter, Jonathan Shamash

Department of Medical Oncology, St Bartholomew’s Hospital, London, United Kingdom

Background: Sunitinib is widely used as first-line treatment for metastatic clear cell renal cancer (MCRC). No reports are known of treatment after sunitinib failure. As irinotecan, cisplatin, and mitomycin-C (IPM) chemotherapy has been reported to influence MCRC after progression on cytokine therapy, we report on the outcome of 11 patients treated with IPM after sunitinib failure.

Patients and methods: Eleven patients with progression of disease on sunitinib therapy were treated with 4, monthly cycles of monthly IPM.

Results: Nine out of 11 patients progressed during IPM therapy. The median time to progression was 1.4 months (95% CI: 0.7–2.1 months), while the overall survival was 4.2 months (95% CI: 0.9–2.3). Overall 10 patients have died of progressive renal cancer. One patient had a radiological response to therapy and remains progression free 11 months after treatment. Four of the 10 patients required a dose reduction for grade 3 or 4 toxicities.

Conclusions: IPM alone does not appear to benefit patients with MCRC who previously progressed during sunitinib therapy. The median progression-free survival and overall survival for these patients is short.

Keywords: renal cancer, chemotherapy, sunitinib