Comparative Analysis between Immunochemotherapy and Target Therapy for Metastatic Renal Cell Carcinoma: Overview of Treatment-Related Adverse Events and the Dropout Rate in Korea

ABSTRACT

PURPOSE: To comparatively analyze treatment-related adverse events and the treatment dropout rate between immunochemotherapy and target therapy in Korea. MATERIALS AND METHODS: Forty-nine subjects with metastatic renal cell carcinoma (21 target therapy recipients and 28 immunochemotherapy recipients) who underwent either 6-week cycles of sunitinib treatment (50 mg once daily for 4 weeks on and 2 weeks off) or 8-week cycles of immunochemotherapy (combination of interleukin [IL]-2, interferon [IFN]-alpha, and 5-fluorouracil [FU]) were enrolled. Treatment-related toxicity was objectively graded and quantitative analysis was performed with a scoring system. Patient compliance was categorized into three classes (1 administration as scheduled, 2 dose modification required, 3 discontinuation required). RESULTS: Compared with those of the immunochemotherapy group, subjects of the sunitinib-treatment group had higher occurrence rates of mucositis-stomatitis (43% vs. 10%), hand-foot syndrome (38% vs. 0%), diarrhea (33% vs. 14%), and hypertension (33% vs. 14%). According to the toxicity-grade-based scoring system, the total incidence and severity of toxicities were not significantly different between the two groups (p>0.05), whereas high-grade hematologic toxicities were more frequent in the immunochemotherapy group. The dropout rate of the immunochemotherapy group was significantly higher than that of the sunitinib group (administration as scheduled 52% vs. 21%, p=0.026; discontinuation required 19% vs. 50%, p=0.037). CONCLUSIONS: The results of this study are indicative of a comparable treatment-related toxicity profile of sunitinib and greater adherence to the treatment protocol in comparison with immunochemotherapy in patients with metastatic renal cell carcinoma (mRCC).