Cancer - Kidney(구연) (E-078) 전이성 투명세포 신세포암 환자에서 sunitinib 유발 초기 용량 제한 독성 및 생존에 대한 중요한 예측 인자로서의 내장 지방의 역할 연세의대 신촌세브란스병원 박지수, 장원식, 김종찬, 이승환, 나군호, 함원식 BACKGROUND: Sunitinib is one of standard first-line treatment options for metastatic renal cell carcinoma (mRCC). Little is known on factors predicting sunitinib-induced dose-limiting toxicity (DLT) in Asian population. OBJECTIVES: We investigated whether body composition by computed tomography (CT) predicted DLT from sunitinib. MATERIALS & METHODS: Korean patients with clear cell mRCC treated with sunitinib (50 mg) were included in this study. Body composition including visceral, subcutaneous, and skeletal muscle cross-sectional area at L3 region was measured in these patients using CT obtained within 1 month before treatment initiation. DLT was defined as any toxicity leading to dose reduction or treatment discontinuation. RESULTS: Among eighty-one mRCC patients for eligible for analysis, twenty-seven patients (33.3%) experienced a DLT during the first cycle of treatment. Significant differences between patients with DLT and without DLT were observed in visceral adipose tissue (VAT) (P = 0.007) and VAT index (VATI) (P = 0.008). Patients who were simultaneously being BMI > 23 kg/m2 and low VATI (VATI less than 24 cm2/m2) experienced no DLT, while remaining patients had all DLTs (P = 0.026). Significant differences were observed between patients with low VATI and high VATI regarding median cancer-specific survival (26.0 months (95% CI: 15.6-36.4) vs. 47.0 months (95% CI: 31.0-63.0), respectively (P = 0.017). CONCLUSIONS: Visceral adiposity was significant predictor of sunitinib associated DLTs and survival in Korean mRCC patients. Patients with low visceral adipose tissue index and BMI > 23 kg/m2 experienced significantly less DLTS during the first cycle of treatment. keywords : sunitinib, renal cell carcinoma, visceral adiposity