Neoadjuvant Sunitinib Effectiveness in T4 Renal Clear Cell Carcinoma: A Case Report. Issue 2 (April 2015)

• Record Type: Journal Article
• Authors: Ricciardulli, Stefano; Del Biondo, Dario; Cicero, Calogero; Leo, Genesio; Zeccolini, Guglielmo; Celia, Antonio
• Is Part Of: Urologia journal. Volume 82:Issue 2(2015)
• Page Start: 109
• Page End: 113
• Publication Date: 2015-04
• Subjects: Sunitinib -- Renal cell carcinoma -- Neoadjuvant therapy -- Tyrosine kinase inhibitor; Urology -- Periodicals; 616.6005
• DOI: 10.5301/uro.5000077
• Languages: English
• ISSNs: 0391-5603

Abstract

Introduction: Sunitinib therapy showed an improvement in survival of patients with metastatic renal cell carcinoma. Materials and Methods: A 51-year-old man, with Eastern Cooperative Oncology Group Score (ECOG) of 0, presented at our Institute in March 2012 for macrohematuria and urinary retention. A computed tomography (CT) scan of the abdomen showed a right renal lesion. The lesion had a diameter of 15 cm and was developing towards the liver, in the absence of cleavage planes between the liver and kidney. A 12 mm finding, suspected as secondary lesion, was detected at the level of the VII hepatic segment. Neoadjuvant chemotherapy with Sunitinib was proposed. Results: The patient underwent a ultrasound-guided biopsy, which confirmed the presence of Clear Cell Carcinoma. The patient began chemotherapy treatment in May 2012 according to the scheme SUNITINIB 50 mg daily for 4 weeks every 6 weeks. After four courses of treatment, according to RECIST criteria for solid tumors, 40% (9 cm vs 15 cm) regression of the primary tumor and 33% (8 mm vs 12 mm) regression of the secondary lesion were observed at a CT scan of the abdomen. In February 2013, Laparoscopic Adrenal-Sparing Radical Nephrectomy was performed. At a follow-up of 3 months, performed with a thorax and abdomen CT scans, there was a complete remission of hepatic secondary lesion and no areas of secondary localization of disease. Conclusions: This case report showed the effectiveness of neoadjuvant chemotherapy with Sunitinib. The use of this chemotherapy agent can change the approach to the management of cRCC.