third‐line sunitinib after failure of first‐line cytokine therapy and second-line sorafenib in patients with clear-cell mRCC. A total of 14 consecutive patients with clear-cell mRCC treated with third-line sunitinib

Third-line sunitinib is occasionally used for selected patients with metastatic renal cell carcinoma (mRCC). The aim of the present study was to evaluate the clinical significance of third‐line sunitinib after failure of first‐line cytokine therapy and second-line sorafenib in patients with clear-cell mRCC. A total of 14 consecutive patients with clear-cell mRCC treated with third-line sunitinib between December 2008 and February 2012 were enrolled in the present study. Disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and relative dose intensity (RDI) were compared with those of first‐line (n=20) and second‐line (n=14) sunitinib treatment. The DCR was 42.9%, the median PFS was 12.0 months, and the median OS was 20.0 months for third-line sunitinib; there were no statistically significant differences compared with first‐line and second‐line sunitinib. The mean RDI was significantly lower for third‐line sunitinib compared with first‐ and second‐line sunitinib (P=0.0003 and 0.0109, respectively). Therefore, third-line sunitinib is an effective treatment option for selected patients with mRCC, as optimized therapeutic efficacy was obtained with a relatively low dose of sunitinib.