Abstract

Background
Sunitinib, an oral tyrosine kinase receptor inhibitor, is the standard first-line therapy for patients with metastatic renal cell carcinoma (mRCC), and has attracted public controversy in the UK over its cost-effectiveness. At recommended dosing of 50 mg daily (4 weeks on, 2 weeks rest), dose delays and reductions from toxicities occur in 40% of patients in a Harvard series (n=35). Since 2007, we have substituted 37.5 mg for the 50 mg starting dose, a regimen that has not been previously reported. We report results from this approach relative to previously conventionally treated patients.

Method
A retrospective review of medical records at a single institution identified 68 evaluable patients with mRCC treated with sunitinib between 2005 and 2009. Median age was 56 years (18-84). 24(35%), 36(53%)