The Life Raft Group surveyed patients and physicians about dosing options for the drug Sutent (sunitinib) to follow up on a 2011 study that showed that patients on a continuous dose exhibited better clinical outcomes than those on the standard four-week on, two-week off dosing regimen. Read our article on the Sutent Treatment Use Trial Results for even more details.
Also be sure to check out the Sutent Physicians Survey Results. Click here for the Word Document.
The study, “Optimizing Management of Sunitinib Treatment in a Worldwide Treatment-use Trial of Patients with Advanced Gastrointestinal Stromal Tumor (GIST),” was done by Dr. Peter Reichardt and colleagues at HELIOS Klinikum Bad Saarow in Germany.
The standard dose of Sutent is 50 mg/day for four weeks, followed by two weeks with no drug. The continuous dose is 37.5 mg/day. The study found that patients on the continuous dosing regimen had fewer side-effects and stayed on the drug longer than those with the standard dose.
Our survey found some gaps in information about the two options.
While 100 percent of the 13 physicians who responded to the survey were aware of the two dosing options, slightly more than half (50.9%) of the 55 patients who responded to our survey said their doctors had not discussed the pros and cons of the two options with them.
Nearly a fifth (18.1%) of patients who responded to the survey said they were not aware of the option of taking Sutent on a continuous basis rather than on the standard four-weeks on, two-weeks off dosage.
When physicians were asked if they ever prescribe the continuous lower dose to GIST patients, 23 percent said always and 61.5 percent said sometimes. Another 15.1 percent said rarely or never.
Nearly half of physicians responding to the survey (46.1%) indicated that the standard dosage has more side-effects than the continuous dosage, while almost a third (30.7%) thought the side-effects were basically equal.
One patient commented: “The patient should know pros and cons and have an input” into the dosage decision. Another said: “I have been on 37.5 and 50 mg … I think the patient should have the final word.”
One physician who uses the continuous dose commented: “Some patients choose the four week on/two week off schedule because they like the feeling of being drug-free for the two weeks and prefer to put up with more side-effects to have the two week holiday.”
Addressing the issue of side-effects, one physician commented: “I take enough time to prepare patients about what could happen and give very clear advice what to do– especially not to wait until activities of daily life are affected. Early skin treatment and individual dose management are absolutely crucial. Hypertension just needs fearless antihypertensive treatment, not discontinuation.”
Of the 10 patients in the survey who had tried both methods, there was an even split over which method had the worse side-effects.
One patient commented: “To handle these nasty side-effects, I contact my doctor, and he recommends actions. Usually these actions are effective for only a limited time. It is not unusual for me to get new side- effects or have existing side-effect changes in either intensity or duration. I am in touch with my doctor quite a bit and much more so than any other drug.”
The survey was done using a Constant Contact survey tool over a two-month period, seeking responses from patients and physicians in the LRG database. We would like to thank all of the GIST survivors and physicians that participated.
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