ORIGINAL RESEARCH article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1590163
This article is part of the Research TopicKidney Cancer Awareness Month 2025: Current Progress and Future Prospects on Kidney Cancer Prevention, Diagnosis and TreatmentView all 6 articles
Incidence and prevalence of organ toxicities in patients suffering from clear cell renal carcinoma treated with sunitinib and its impact on survival : a reference cancer center experience
Provisionally accepted
Agata Sałek-Zań*
Miroslawa Puskulluoglu
Justyna JaworskaAgnieszka PietruszkaJoanna LompartMarek ZiobroTomasz Banaś- Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, Poland
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Introduction: Tyrosine kinase inhibitors (TKIs) are the standard treatment options for advanced clear cell renal cell carcinoma (ccRCC), but their toxicities can hinder optimal dosing, affecting clinical outcomes.Material and methods: A retrospective analysis of 96 patients treated with first-line line sunitinib at the National Research Institute of Oncology, Branch Kraków, Poland was conducted to assess the incidence and prevalence of organ toxicities in ccRCC and their impact on overall survival (OS).Results: The study included 96 patients. The median number of treatment cycles was 11 (IQR: 19), and the median duration was 63 weeks (IQR: 95). The most common toxicities were gastrointestinal (76.0%), fatigue (61.5%), and cardiovascular (49.0%), with 81.3% of patients experiencing multi-organ toxicity. Dose delays occurred in 37 patients (38.5%), mainly due to gastrointestinal (38.5%) and cardiovascular toxicity (21.9%). Dose reductions were required in 64 patients (66.7%), primarily for gastrointestinal (39.6%) and cardiovascular (16.7%) complications. Cardiotoxicity (p=0.017) correlated with improved OS. No OS differences were observed in enterotoxicity, hematologic, endocrine, dermatologic, or renal toxicity. Patients requiring dose reduction due to cardiotoxicity (p=0.012), haematologic toxicity (p=0.004) or gastrointestinal toxicity (p=0.004) had better survival than those without modifications. Patients requiring dose reduction due to any cause had better OS than those maintaining the initial dose. The timing or frequency of dose reductions had no significant impact.Conclusions: Cardiotoxicity, gastrointestinal and haematologic toxicities requiring dose reduction were associated with improved survival, suggesting these toxicities may reflect treatment efficacy. The findings emphasize the need to balance toxicity and treatment continuity.
Keywords: Renal cell carcinoma, tyrosine kinase inhibitors, adverse events, Survival, Sunitynib
Received: 08 Mar 2025; Accepted: 31 Jul 2025.
Copyright: © 2025 Sałek-Zań, Puskulluoglu, Jaworska, Pietruszka, Lompart, Ziobro and Banaś. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Agata Sałek-Zań, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, Poland
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