First-line sunitinib versus pazopanib in metastatic renal cell carcinoma: Results from the International Metastatic Renal Cell Carcinoma Database Consortium.

Abstract

BACKGROUND:

Sunitinib (SU) and pazopanib (PZ) are standards of care for first-line treatment of metastatic renal cell carcinoma (mRCC). However, how the efficacy of these drugs translates into effectiveness on a population-based level is unknown.

PATIENTS AND METHODS:

We used the International mRCC Database Consortium (IMDC) to assess overall survival (OS), progression-free survival (PFS), response rate (RR) and performed proportional hazard regression adjusting for IMDC prognostic groups. Second-line OS (OS2) and second-line PFS (PFS2) were also evaluated.

RESULTS:

We obtained data from 7438 patients with mRCC treated with either first-line SU (n = 6519) or PZ (n = 919) with an overall median follow-up of 40.4 months (95% confidence interval [CI] 39.2-42.1). There were no significant differences in IMDC prognostic groups (p = 0.36). There was no OS difference between SU and PZ (22.3 versus 22.6 months, respectively, p = 0.65). When adjusted for IMDC criteria, the hazard ratio (HR) of death for PZ versus SU was 1.03 (95% CI 0.92-1.17, p = 0.58). There was no PFS difference between SU and PZ (8.4 versus 8.3 months, respectively, p = 0.17). When adjusted for IMDC criteria, the HR for PFS for PZ versus SU was 1.08 (95% CI 0.981-1.19, p = 0.12). There was no difference in RR between SU and PZ (30% versus 28%, respectively, p = 0.15). We also found no difference in any second-line treatment between either post-SU or post-PZ groups for OS2 (13.1 versus 11 months, p = 0.27) and PFS2 (3.7 versus 5.0 months, p = 0.07).

CONCLUSIONS:

We confirmed in real-world practice that SU and PZ have similar efficacy in the first-line setting for mRCC and do not affect outcomes with subsequent second-line treatment.

• Authors: Jose Manuel Ruiz-Morales, Marcin Swierkowski, J Connor Wells, Anna Paola Fraccon, Felice Pasini, Frede Donskov, Georg A Bjarnason, Jae-Lyun Lee, Hao-Wen Sim, Andrzej Sliwczynsk, Aneta Ptak-Chmielewska, Zbigniew Teter, Benoit Beuselinck, Lori A Wood, Takeshi Yuasa, Carmel Pezaro, Brian I Rini, Cezary Szczylik, Toni K Choueiri, Daniel Y C Heng
• Journal: European journal of cancer (Oxford, England : 1990) (Eur J Cancer) Vol. 65 Pg. 102-8 (09 2016) ISSN: 1879-0852 [Electronic] England
• PMID: 27487293 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.

Chemical References

• Antineoplastic Agents
• Indazoles
• Indoles
• Protein Kinase Inhibitors
• Pyrimidines
• Pyrroles
• Sulfonamides
• pazopanib
• Sunitinib

Topics

• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Carcinoma, Renal Cell (drug therapy, mortality)
• Disease-Free Survival
• Humans
• Indazoles
• Indoles (therapeutic use)
• Kidney Neoplasms (drug therapy, mortality)
• Middle Aged
• Molecular Targeted Therapy (methods)
• Prognosis
• Proportional Hazards Models
• Protein Kinase Inhibitors (therapeutic use)
• Pyrimidines (therapeutic use)
• Pyrroles (therapeutic use)
• Retrospective Studies
• Sulfonamides (therapeutic use)
• Sunitinib