Dose escalation of second-line sunitinib results in rapid partial remission of multiple hepatic metastases.

A 58-year-old man with metastatic clear cell renal cell carcinoma on sunitinib therapy, who previously failed on sorafenib, was found to have progression of multiple hepatic metastases; he was on a standard sunitinib dose of 50 mg/day (4 weeks on, 2 weeks off). Due to the unavailability of alternative therapies, a sunitinib dose escalation of 50 mg/day was attempted. After one 6-week cycle of continuously dosed sunitinib 50 mg, the hepatic lesions regressed. After the second cycle, virtual disappearance of the lesions was recorded. There was no added toxicity. These findings suggest that sunitinib dose escalation to 50 mg/day using continuous daily administration dosing might represent a valid, effective and well-tolerated therapeutic option in patients who progress on standard sunitinib therapy.