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