Bladder Cancer Update & Renal Cell Cancer Update, 2017 (Video Program)Management of dermatologic toxicities associated with sunitinib
2:51 minutes.
TRANSCRIPTION:
DR LOVE: Any pearls of wisdom in terms of getting people through sunitinib, more typically in the metastatic but even in the adjuvant situation, anything that you think you’ve learned that you’d like to share? DR MOTZER: I think for me, probably the most problematic adverse event or side effect from sunitinib is the hand-foot skin reaction. When I see that, that really interferes with people’s activities of daily living. And so I know there are other side effects that are more common, like fatigue and diarrhea and so forth, but it’s really that hand-foot syndrome that interferes with the patients’ daily routine. So we are very proactive with having the patients see a dermatologist who’s well versed with the management of that. And we maximize topical ointments for that. We encourage the use of soft-soled shoes. But if it just continues as problematic, I mean, then we dose reduce, because the patients need to be active and have good quality of life. That’s part of the purpose of these outpatient long-term regimens. DR LOVE: I know that Mario Lacouture, the dermatologic oncologist, is at Memorial. And has he been involved with these patients? Any special pearls from him? DR MOTZER: Yes. So Mario is my key person with regard to management of dermatologic issues with sunitinib and all of these targeted drugs. And so I think that he’s very effective with that. And I know he has educational activities that he does with regard to that. And I think those are very important. DR LOVE: So getting back to the basic question here: As a result of the S-TRAC data, are you now bringing up the issue of off-protocol adjuvant therapy, and are you actually treating patients? DR MOTZER: I have been holding off on that, because at this point adjuvant sunitinib is not included in the NCCN Guidelines. It also has not received regulatory approval for that purpose. So with the release of the sunitinib Phase III trial in October, I mean, I’ve been mentioning it to patients and discussing it with them, but I haven’t actually utilized sunitinib in the adjuvant setting. I’m waiting for review by the NCCN and, also very important, the regulatory decision on whether it should be given as part of standard of care. |