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Gonzalez et al. J Cancer Metastasis Treat 2016;2:396-401 Journal of
DOI: 10.20517/2394-4722.2016.27
Cancer Metastasis and Treatment

www.jcmtjournal.com
Original Article Open Access

Sunitinib effectiveness and safety as first
line treatment in metastatic renal cell

carcinoma, in the Costa Rican population

Esteban Gonzalez , Silvia Alfaro , Allan Ramos-Esquivel , Denis Ulises Landaverde 1,4
1
2
3,4
1 Department of Hemato-Oncology, Hospital Mexico, La Uruca, San Jose 10107, Costa Rica.
2 Department of Hemato-Oncology, Hospital Calderon Guardia, Guadalupe, San Jose 10801, Costa Rica.
3 Department of Hemato-Oncology, Hospital San Juan de Dios, Distrito Hospital, San Jose 10103, Costa Rica.
4 Department of Medicine, Universidad de Costa Rica, San Pedro de Montes de Oca, San José 2060, Costa Rica.
Correspondence to: Dr. Denis Ulises Landaverde, Department of Hemato-Oncology, Hospital Mexico, CCSS, 76th Street, 41st Avenue, La Uruca,
San Jose 10107, Costa Rica. E-mail: denislandaverde@gmail.com; denis.landaverderecinos@ucr.ac.cr
How to cite this article: Gonzalez E, Alfaro S, Ramos-Esquivel A, Landaverde DU. Sunitinib effectiveness and safety as first line treatment in
metastatic renal cell carcinoma, in the Costa Rican population. J Cancer Metastasis Treat 2016;2:396-401.
Dr. Denis Ulises Landaverde completed his medical degree and postgraduate training in Medical Oncology at the
University of Costa Rica and also completed a fellowship in Breast Cancer at the University of Toronto, Canada.
Currently he is the Chief of Medical Oncology Division at Mexico Hospital, in San Jose, and Professor of Medicine at
the University of Costa Rica.

ABSTRACT
Article history: Aim: Tyrosine kinase inhibitors are part of the armamentarium to treat metastatic renal
Received: 22-05-2016 cell carcinomas (mRCC). Costa Rica has approved sunitinib in the first line setting. The
Accepted: 23-07-2016 authors conducted a retrospective study to address the effectiveness and safety profile of
Published: 21-10-2016 sunitinib in our population in terms of overall survival (OS) and progression free survival
(PFS). Methods: The authors analyzed all patients who were treated with sunitinib
Key words: diagnosed with mRCC in the three National Hospitals (Hospital Mexico, Hospital San Juan
Sunitinib, de Dios, and Hospital Calderon Guardia) from February 2007 to June 2015. Demographics,
renal cell carcinoma, safety profile, and efficacy (OS and PFS) were obtained from medical records. OS and PFS
effectiveness, were calculated using the Kaplan Meier method and a Cox Proportional Model Analysis
Latin America, was used when OS and PFS were compared in subset of patients. Results: Seventy-seven
Costa Rica patients were included; mean age was 58.9 years. Fifty-four patients were male (70.1%).
The most common histologic type was clear cell carcinoma (87%), followed by papillary
(9.1%) and chromophobe (2.0%) types. Median OS was 21.0 months [95% confidence
interval (CI): 13.42-28.58]. Median PFS was 13.7 months (95% CI: 11.24-16.16). Patients
aged 65 years or older experienced worse PFS and OS than younger patients (median PFS:
8.2 vs. 17.6 months; P = 0.011) (median OS: 19.0 vs. 29.0 months; P = 0.022). Sunitinib was
well tolerated and no serious side effects were reported. Conclusion: This is the first study
in Central America showing that sunitinib, first line, in mRCC is as effective as reported in
pivotal clinical trials and expanded use studies in terms of PFS and OS.
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