An alternative “weekday-on and weekend-off regimen” of sunitinib administration for metastatic renal cell carcinoma (RCC) may improve relative dose intensity compared with the conventional schedule, according to investigators.

In a prospective study, Atsunari Kawashima, MD, of the Graduate School of Medicine at Osaka University in Osaka, Japan, compared the alternative schedule and conventional schedules in 58 patients with metastatic RCC. Patients had a median age of 66 years (range 43 to 85 years), and 47 patients (81%) were male. The initial sunitinib dose was 50 mg for 33 patients (56.9%) and 37.5 mg for 25 patients. The investigators tested the alternative schedule as a way to reduce the ratio of severe adverse events (AEs) and improve relative dose intensity.

For the alternative schedule, 20 patients received sunitinib only on 5 consecutive days for 2 weeks and 3 consecutive days for 1 week.  The alternative schedule had the same dose intensity every 6 weeks as the conventional schedule. The conventional schedule was 4 weeks on suninitib and 2 weeks off. The outcome measure was relative dose intensity for the first 6 weeks (6W-RDI).

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The 6W-RDI was significantly higher among patients receiving the alternative than the conventional regimen (77.2% vs 70.4%), the investigators reported in the International Journal of Clinical Oncology. On multivariate analysis, the alternative schedule was associated with significant 3.6-fold increased odds of maintaining 6W-RDI above 75% compared with the conventional schedule.

The study found no significant between-group differences in AE rate and prognoses.


Kawashima A, Uemura M, Kato T, et al. Results of weekday-on and weekend-off administration schedule of sunitinib therapy for advanced renal cell carcinoma. Int J Clin Oncol. 2018; published online ahead of print.