Article visceral adiposity as a significant predictor of sunitinib-induced dose-limiting toxicities and survival in patients with metastatic clear cell renal cell carcinoma

Jee Soo Park, Kyo Chul Koo, Doo Yong Chung, Sun Il Kim, Jeongho Kim, Cheol Kyu Oh, Tae Nam Kim, Sung Ku Kang, Jae Won Park, Young Eun Yoon, Sung Yul Park, Koon Ho Rha, Won Sik Ham

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Abstract

Sunitinib is a first-line treatment for metastatic renal cell carcinoma (mRCC). Little is known about the predictive factors of sunitinib-induced dose-limiting toxicity (DLT) in Asian populations. We investigated whether body composition predicts sunitinib-induced DLT. We retrospectively reviewed sunitinib-treated Korean patients with clear cell mRCC from eight institutions. Body composition was measured using computed tomography. DLT was defined as any adverse event leading to dose reduction or treatment discontinuation. Univariate analysis was used to compare body composition indices, and logistic regression analyses were performed for factors predicting early DLT. Overall, 111/311 (32.5%) of patients experienced DLT. Significant differences were observed in the subcutaneous adipose tissue index (SATI; p = 0.001) and visceral adipose tissue index (VATI; p < 0.001) between patients with and without DLT. Multivariate analyses revealed that VATI (odds ratio: 1.013; p = 0.029) was significantly associated with early DLT. Additionally, 20% of patients who had a body mass index (BMI) greater than 23 kg/m2 and a low VATI experienced DLT, whereas 34.3% of the remaining groups had DLT (p = 0.034). Significant differences were observed for median progression-free survival (13.0 vs. 26.0 months, respectively; p = 0.006) between patients with low and high VATI. Visceral adiposity was a significant predictor of sunitinib-associated DLT and survival. Patients with a low VATI and a BMI greater than 23 kg/m2 experienced lower DLTs.

Original languageEnglish
Article number3602
Pages (from-to)1-11
Number of pages11
JournalCancers
Volume12
Issue number12
DOIs
Publication statusPublished - 2020 Dec

Bibliographical note

Funding Information:
Funding: This research was funded by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea, grant number HI17C1095; and the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT), grant number 2019R1A2C1002863.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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