Activity and safety of sunitinib in poor risk metastatic renal cell carcinoma patients

Purpose To assess the activity, safety and treatment patterns of sunitinib in patients with poor-risk metastatic renal cell carcinoma (mRCC). Materials and Methods We retrospectively reviewed the charts of poor risk patients treated with sunitinib from October 2006 to July 2013 who met the eligibility criteria. The primary endpoint was overall survival (OS). Tumor radiological response was measured according to RECIST 1.1 and adverse events (AEs) were assessed through standard criteria. Results Median OS was 8.16 months (95% CI, 5.73-10.59). Of the 53 patients included in this analysis, 9 (17.0%) achieved partial response, 12 (22.6%) had stable disease. Median treatment duration was 3.30 months (95% CI: 1.96-4.63) and 26.4% of patients discontinued treatment due to toxicity. Grade 3 or higher AEs occurred in 39.6% of patients, the most common being fatigue (15.1%), neutropenia (9.5%), nausea, vomiting and diarrhea (7.5% each). Discussion Sunitinib may benefit some unselected poor-risk patients, although the rates of AEs and drug discontinuation suggest a need for careful patient monitoring. .

Bloqueio androgênico no câncer de próstata como causa de síndrome metabólica / Metabolic syndrome due to androgen deprivation in prostate cancer

O adenocarcinoma de próstata é o câncer mais comum no sexo masculino após o câncer de pele. Dentre as várias formas de tratamento do câncer de próstata, a terapia de bloqueio androgênico é uma modalidade consagrada nos pacientes com doença metastásica ou localmente avançada, e que provavelmente resulta em aumento de sobrevida. No entanto, o bloqueio androgênico é causador de uma série de consequências adversas. Complicações como osteoporose, disfunção sexual, ginecomastia e anemia são bem conhecidas. Recentemente uma série de complicações metabólicas foi descrita, como aumento da circunferência abdominal, resistência à insulina, hiperglicemia, diabetes, dislipidemia e síndrome metabólica, com consequênte aumento do risco de eventos coronários e mortalidade cardiovascular nessa população específica.

Prostate adenocarcinoma is the most prevalent cancer in men after skin cancer. Between the various prostate cancer treatment modalities, androgen deprivation is a recognized modality in patients with metastatic or locally advanced disease, which likely improves survival. However, androgen deprivation is a cause of important side effects. Complications such as osteoporosis, sexual dysfunction, gynecomastia and anemia are well known. Recently, a series of metabolic complications have been reported such as increased abdominal circumference, insulin resistance, diabetes, dyslipidemia and metabolic syndrome, leading to an increase in coronaries events and cardiovascular mortality in this specific population.

Acidente vascular cerebral isquêmico após quimioterapia com cisplatina, etoposide e bleomicina. Relato de caso / Ischemic stroke after chemotherapy with cisplatin, etoposide and bleomycin: case report

Relatamos o caso de um homem de 20 anos, com diagnóstico de tumor de células germinativas, que apresentou acidente vascular cerebral isquêmico durante quimioterapia com cisplatina, etoposide e bleomicina. Os casos relatados na literatura foram revisados, bem como os diferentes mecanismos fisiopatológicos implicados na toxicidade vascular deste esquema quimioterápico