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Acta Medica Medianae
Correspondence to:
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Original article DERMATOLOGICAL ADVERSE EFFECTS OF SUNITINIB IN PATIENTS WITH RENAL CELL CARCINOMA: CASE-CONTROL STUDY
Bojana Petrović, Sinisa Radulović and Slobodan Janković
Medicinski fakultet, Univerzitet u Kragujevcu, Srbija1 Institut za onkologiju i radiologiju Srbije, Beograd, Srbija2
Sunitinib is
small, lipophilic, synthetic molecule that interferes with
tyrosine-kinase domain of vascular endothelial growth factor
receptor, and prevents its activation after binding the vascular
endothelial growth factor. Both in vitro and in vivo, sunitinib
inhibits angiogenesis and suppresses growth of metastases, which
depends on newly formed blood vessels. It was already approved by
FDA (U.S. Food and Drug Administration) in January 2006 for
treatment of advanced renal-cell cancer and imatinib-resistant
gastrointestinal stromal tumours. Among adverse effects, it causes
skin desquamation on fingers and toes, whitening of hair, eyebrows,
mustache and beard. The aim of our study was to prove the causal
relationship between sunitinib administration and skin adverse
effects. The study involved the patients with metastasized renal
cell carcinoma treated at the Institute for Radiology and Oncology
of Serbia, in Belgrade. There were twelve patients (mean age 53.3 ±
11.1 years) who took sunitinib 50 mg daily, for 4 weeks (“cases”).
Control group was composed of fourteen patients (mean age 54.6 ± 9.8
years) on standard therapy with interferon alpha (6 MJ three times
weekly) and vinblastine 10 mg, two days per cycle. The control
patients were matched with “cases” by age, sex, phase of the disease
and nephrectomy. Out of patients who received sunitinib, eleven
(92%) developed desquamation on fingers and toes, whitening of hair,
eyebrows, mustache and beard, while none of the skin adverse effects
was observed in the control group (OR=143). The distribution of
hypertension, heart diseases and diabetes mellitus in the groups was
not significantly different (p>0.05). There is a strong association
between administration of sunitinib in patients with renal cell
carcinoma and observed skin adverse effects. Acta Medica Medianae
2009;48(3):5-8. Key words: sunitinib, hand-foot syndrome, angiogenesis |