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Editor’s note: Sunitinib malate has shown increased progression-free survival and a trend toward increased overall survival compared with interferon-
α in the treatment of metastatic renal cell carcinoma (mRCC). The incidence of treatment-related decline of left ventricular ejection fraction (LVEF) has been heterogeneously described in prospective and retrospective studies. In the first-line treatment of advanced RCC with sunitinib, Motzer et al. found LVEF decline in 10% of patients (
N Engl J Med 2007;356:115–24), whereas Chu et al. reported LVEF decline in 28% of patients (
Lancet 2007;370:2011–9). Demetri et al. reported no mean reduction in LVEF with sunitinib in the second-line treatment of gastrointestinal stromal tumors (
Lancet 2006;368:1329–38). Moreover, retrospective studies have reported an incidence of sunitinib-related grade 3 hypertension of 9.7% (
Ann Oncol 2009;20:1535–42) and of grade 3/4 heart failure of 15% (
Ann Oncol 2008;19:1613–8) in patients with RCC.