Carcinoma of the collecting ducts of Bellini of the kidney: adjuvant chemotherapy followed by multikinase-inhibition with sunitinib.
Eur J Med Res
; 13(11): 531-5, 2008 Nov 24.
Article
en En
| MEDLINE
| ID: mdl-19073390
ABSTRACT
INTRODUCTION:
Carcinoma of the collecting ducts of Bellini of the kidney (CDC) is very rare but among the most aggressive urological entities. Standard therapy is not well defined with questionable efficacy.METHODS:
We present two cases of male patients (49 and 66 years old) with pT3a pN2 CDC treated with a combination of cisplatin plus gemcitabine in an adjuvant setting. Following recurrence the multi-kinase inhibitor sunitinib was administered.RESULTS:
Radical nephrectomy with lymphadenectomy revealed CDC in stage pT3a pN2 M0 G3 R0 in both patients. 4 courses of adjuvant chemotherapy with cisplatin 70 mg/m superset2 and gemcitabine 1,500 mg/m superset2 were given. Side effects according to the NCI 3.0 common toxicity criteria were limited to grade 2 asthenia and grade 2 thrombozytopenia/leucopenia. Restaging revealed local recurrence and lymph node metastases. Both patients were re-operated and metastatic CDC was found. Second line therapy with sunitinb malatat (Sutent superset, Pfizer Inc. U.S.) at 50mg p.o. was given. Grade 3 leucopenia and thrombocytopenia and grade 2 asthenia and mucositis were not dose-limiting. After two cycles multiple liver, lung and bone metastases and mediastinal lymphopathy occured. 8 weeks later the patients died with a survival of 8 months from initial diagnosis.CONCLUSIONS:
Adjuvant gemcitabine plus cisplatin did not delay recurrence of CDC after surgery. Metastasectomy either had no influence on the course of disease. Anti-angiogenetic therapy with sunitinib treatment was not effective, possibly related to a low vascular density (CD31 expression) in CDC.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Pirroles
/
Carcinoma de Células Renales
/
Protocolos de Quimioterapia Combinada Antineoplásica
/
Indoles
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Neoplasias Renales
/
Antineoplásicos
Límite:
Aged
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Med Res
Asunto de la revista:
MEDICINA
Año:
2008
Tipo del documento:
Article
País de afiliación:
Alemania