医学
舒尼替尼
安慰剂
人口
内科学
不利影响
安慰剂对照研究
随机对照试验
药代动力学
肿瘤科
药理学
外科
泌尿科
胃肠病学
癌症
病理
双盲
替代医学
环境卫生
作者
Syed Shariq Naeem,Pooja Gupta,Ranjit Kumar Sahoo,Vivek Kumar,Thirumurthy Velpandian,Abhishek Singh,Atul Batra,Raja Pramanik,Sameer Rastogi,Saumya Srivastava
标识
DOI:10.1016/j.clgc.2024.102073
摘要
Abstract
Introduction
Hand foot skin reaction (HFSR) is a common dose-limiting adverse effect of multi kinase inhibitors (MKI) whose mechanism is not fully understood, and the prophylaxis is inadequate. Objective
In this pilot study, a double-blind, randomized placebo-controlled trial was conducted to evaluate the effect of topical urea in secondary prevention of sunitinib-induced HFSR in renal cell cancer patients. Methods
Out of 55 screened patients, 14 were randomized to receive topical urea or placebo for four weeks. The association of HFSR with drug levels of sunitinib and its metabolite (n-desethyl sunitinib), genetic polymorphism of VEGFR2 gene, quality of life (QOL) and biochemical markers was also assessed. Results
The results showed that urea-based cream was not superior to placebo (p = 0.075). There was no change in the QOL in both the groups. Single nucleotide polymorphism was checked for two nucleotides rs1870377 and rs2305948 located in VEGFR2 gene on chromosome 4. SNP (variant T>A) at rs1870377 was associated with appearance of new HFSR as compared to the wild type, although the association was not statistically significant (OR 0.714). There was no statistically significant difference between mean plasma levels of sunitinib and N-desethyl sunitinib in urea arm as comparted to placebo arm as compared to placebo. The best fit population pharmacokinetic model for sunitinib was one compartment model with first order absorption and linear elimination. The median (IQR) of population parameters calculated from the population pharmacokinetics model for Ka, V and Cl was 0.22 (0.21-0.24) h-1, 4.4 (4.09-4.47) L, 0.049 (0.042-0.12) L/hr, respectively. Conclusion
The study suggested that the urea-based cream was not superior to placebo in decreasing the appearance of new HFSR in renal cancer patients receiving 4:2 regimen of sunitinib.
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