Case Report of Prolonged Stable Disease with Modified Schedule Sunitinib in Metastatic Renal Cell Carcinoma

Abstract

Background: New targeted therapies have revolutionized the treatment landscape of metastatic renal cell carcinoma over the last decade. Sunitinib has demonstrated high activity in renal cell carcinoma (RCC), still complete remission is not a common occurrence in patients. In patient achieving complete response, continuation of therapy beyond complete response is debatable. Cytoreductive nephrectomy has shown to be beneficial in metastatic renal cell carcinoma in patients treated with interferon. However, its role is not established in the targeted therapy era. Case Presentation: A patient was diagnosed with renal clear cell carcinoma with multiple pulmonary metastases. He underwent cytoreductive nephrectomy and was started Sunitinib post-operatively. He experienced toxicities which were manageable with dose adjustments. He showed significant improvement on sunitinib therapy demonstrating complete response after total 22 months of therapy. After careful consideration and discussion with patient, sunitinib was stopped. The patient continues to be in an excellent condition after having stopped Sunitinib 5 years ago. Conclusions: This case highlights that complete response can be achieved by sunitinib post cytoreductive nephrectomy with good quality of life and manageable toxicities. The case also highlights that discontinuation of therapy can be an option for some patients.