Asian patients should get lower dose of kidney cancer drug
A seven-year clinical study has revealed that a lower dose of the metastatic renal cell carcinoma (mRCC) drug sunitinib can be used in Asian patients, reducing the side effects without compromising the effectiveness. This research has been published in the journal Clinical Genitourinary Cancer. The new treatment regimen for sunitinib has been accepted by oncologists in Singapore. For the patients, this would mean an estimated 30 % reduction in fees because of the lower dosage. The median overall survival rate was 27.4 as compared to 21.8 months among patients receiving the attenuated dosage.
Sunitinib was introduced as a treatment for mRCC in Singapore since early 2005. The US Food and Drug Administration (FDA) approved dosing of sunitinib is 50mg once daily for four weeks, followed by a two-week break in a six-week treatment cycle. Subsequent findings from 2005 to 2006 show that high toxicities were observed with the conventional dosing, especially in Asians.
“Many of the patients were experiencing severe side effects with the conventional dosing. Our immediate response was to refine the treatment protocol to improve patients’ quality of life”, explained Dr. Tan Min Han from the genitourinary oncology team at the National Cancer Center Singapore (NCCS).
NCCS initiated a prospective clinical registry with 127 mRCC patients receiving a lower dose of sunitinib of 37.5mg/d/4/2 (37.5mg of sunitinib once daily for four weeks, followed by a two-2 week break) as treatment protocol in 2007. Clinical data of patients receiving sunitinib at NCCS from 2005 to 2012 and three other tertiary centers in Singapore (Johns Hopkins-International Medical Centre, National University Hospital Singapore, and Onco-Care of Gleneagles Medical Centre) from 2005 to 2009 were used for comparison, representing at least 90 % of all patients with mRCC treated over the period.
The data revealed favorable results between the attenuated dosing regimen compared to the conventional dosing. 59 % of the participants experienced severe side effects as compared to the previous 85 %; 24 % than 58 % required reduction in dose delays; and 35 % rather than 70 % of patients requiring dose reduction during their course of treatment. Both dose delays and reduction are only required when high level of toxicities are observed. – Asia Scientist
Category: Features, Health alert
