Alessandria del Carretto, Italy
Alessandria del Carretto, Italy

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Leonetti A.,University of Parma | Bersanelli M.,University of Parma | Castagneto B.,San Giacomo Hospital Novi Ligure | Masini C.,University of Modena and Reggio Emilia | And 3 more authors.
Clinical Genitourinary Cancer | Year: 2016

Few data are available about sorafenib use in patients with metastatic renal cell carcinoma (mRCC) undergoing hemodialysis. No systematic review has been previously performed about this issue. The objective of the present review is to investigate pharmacokinetics and clinical outcomes of sorafenib in mRCC patients undergoing hemodialysis. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, all the literature about mRCC dialysis patients receiving sorafenib, published from January 1946 to August 2015, was evaluated. Applying inclusion/exclusion criteria, 11 articles were selected for the analysis; 1 patient from our department was also included. The investigated outcomes were pharmacokinetics, toxicity, response rate, progression-free survival, and overall survival where available. A total of 36 patients were included. Median treatment duration was 6.0 months on overall population; median progression-free survival was 6.3 months (calculated on 19 patients); response rate was 22% (on 29 patients); median overall survival was 14.9 months (on 28 patients). Of note, 24 patients started sorafenib at reduced dose; 6 of 36 patients (17%) required dose reduction due to adverse events (AEs). Sorafenib treatment was discontinued in 7 patients (19%) because of AEs. Most of AEs were Grade 1-2; severe toxicities (Grade 4-5) included G4 anemia (1 case), G4 hypertension (1 case), G4 cerebellar hemorrhage (1 patient), and a case of G5 subarachnoid hemorrhage. This review confirmed the efficacy of sorafenib treatment in mRCC patients receiving hemodialysis. Nevertheless, drug toxicity seems to be increased in these patients, despite the initiation of therapy at reduced doses; therefore, sorafenib should be used with caution in dialysis patients. © 2016 Elsevier Inc.


PubMed | University of Parma, San Giacomo Hospital Novi Ligure, University of Modena and Reggio Emilia and Hospital of Bolzano
Type: Journal Article | Journal: Clinical genitourinary cancer | Year: 2016

Few data are available about sorafenib use in patients with metastatic renal cell carcinoma (mRCC) undergoing hemodialysis. No systematic review has been previously performed about this issue. The objective of the present review is to investigate pharmacokinetics and clinical outcomes of sorafenib in mRCC patients undergoing hemodialysis. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, all the literature about mRCC dialysis patients receiving sorafenib, published from January 1946 to August 2015, was evaluated. Applying inclusion/exclusion criteria, 11 articles were selected for the analysis; 1 patient from our department was also included. The investigated outcomes were pharmacokinetics, toxicity, response rate, progression-free survival, and overall survival where available. A total of 36 patients were included. Median treatment duration was 6.0 months on overall population; median progression-free survival was 6.3 months (calculated on 19 patients); response rate was 22% (on 29 patients); median overall survival was 14.9 months (on 28 patients). Of note, 24 patients started sorafenib at reduced dose; 6 of 36 patients (17%) required dose reduction due to adverse events (AEs). Sorafenib treatment was discontinued in 7 patients (19%) because of AEs. Most of AEs were Grade 1-2; severe toxicities (Grade 4-5) included G4 anemia (1 case), G4 hypertension (1 case), G4 cerebellar hemorrhage (1 patient), and a case of G5 subarachnoid hemorrhage. This review confirmed the efficacy of sorafenib treatment in mRCC patients receiving hemodialysis. Nevertheless, drug toxicity seems to be increased in these patients, despite the initiation of therapy at reduced doses; therefore, sorafenib should be used with caution in dialysis patients.


Castagneto B.,San Giacomo Hospital Novi Ligure | Stevani I.,San Giacomo Hospital Novi Ligure | Giorcelli L.,San Giacomo Hospital Novi Ligure | Montefiore F.,San Giacomo Hospital Novi Ligure | And 3 more authors.
Medical Oncology | Year: 2011

The prognosis for patients with renal cell carcinoma is very poor, with a five-year survival rate of less than 10%. Sorafenib is an orally administered multikinase inhibitor that blocks intracellular kinases in the Raf/MEK/ERK pathway involved in tumor proliferation, and also kinases responsible for angiogenesis, including VEGFr-2, VEGFr-3, Flt-3, PDGFr-β and c-KIT. As a consequence of its limited renal clearance, sorafenib appears to be suitable for patients with advanced kidney cancer and terminal renal failure. The case of a 72-year-old male patient on hemodialysis and receiving sorafenib treatment for mRCC is reported. © 2010 Springer Science+Business Media, LLC.

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