コバヤシ　ヒロヒト   Kobayashi Hirohito   小林　博人    所属   医学部 医学科（附属足立医療センター）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Decreased relative dose intensity during the early phase of treatment impacts the therapeutic efficacy of sunitinib in metastatic renal cell carcinoma.
掲載誌名	正式名：Japanese journal of clinical oncology 略　 称：Jpn J Clin Oncol ISSNコード：14653621/03682811
掲載区分	国外
巻・号・頁	48(7),pp.667-672
著者・共著者	ISHIHARA Hiroki†*, TAKAGI Toshio, KONDO Tsunenori, IWAMOTO Kana, TACHIBANA Hidekazu, YOSHIDA Kazuhiko, OMAE Kenji, IIZUKA Junpei, KOBAYASHI Hirohito, TANABE Kazunari
発行年月	2018/07
概要	Background:Relative dose intensity is an indicator of therapeutic efficacy in sunitinib treatment for metastatic renal cell carcinoma. However, the number of studies investigating the influence of decreased relative dose intensity during the early phase on oncological outcome is limited.Methods:A total of 105 patients who received first-line sunitinib treatment for metastatic renal cell carcinoma were evaluated. We assessed the relative dose intensity during the initial first cycle (1c-RDI). We found that an optimal threshold of 1c-RDI was associated with progression-free survival and overall survival after the initiation of sunitinib treatment. Additionally, predictive factors for decreased 1c-RDI were analyzed.Results:The 1c-RDI threshold was determined at 60%. Patients with low 1c-RDI (<60%, n = 26, [24.8%]) had significantly shorter median progression-free survival (5.79 vs. 14.0 months, P = 0.0014) and overall survival (13.3 vs. 34.4 months, P = 0.0005) durations than those with high 1c-RDI (≥60%, n = 79 [75.2%]). Multivariate analysis showed that the development of dose-limiting toxicity was an independent factor for low 1c-RDI (odds ratio: 3.09, 95% confidence interval: 1.14-8.37, P = 0.0266) after adjustment with an initial dose of sunitinib.Conclusions:More than 60% of 1c-RDI is needed for effective sunitinib treatment. Patient tolerability should be carefully monitored to avoid the development of dose-limiting toxicity during the early phase of treatment.
DOI	10.1093/jjco/hyy078
PMID	29860353