Our website uses cookies to improve your on-site experience. By using the website, cookies are being used as described in our Policy Document
Warning: To log in you will need to enable cookies and reload the page (Policy Document)
My ePortfolio Register   
 

Abstract | Full HTML Article | PDF ecancer 13 973 / https://doi.org/10.3332/ecancer.2019.973

Research

Real-world evidence on first-line treatment for metastatic renal cell carcinoma with non-clear cell and sarcomatoid histologies: are sunitinib and pazopanib interchangeable?

Introduction: Non-clear cell renal cell carcinoma (nccRCC) and sarcomatoid renal cell carcinoma (sRCC) are underrepresented in clinical trials. Treatment approaches are frequently extrapolated from data of clear cell renal cell carcinoma, in which pazopanib is non-inferior to sunitinib. We aim to compare the effectiveness of first-line sunitinib and pazopanib for nccRCC and sRCC.

Methods: We evaluated a retrospective cohort of patients with metastatic nccRCC and sRCC treated with first-line sunitinib or pazopanib at an academic cancer centre. Overall survival (OS), progression-free survival (PFS) and response rate were measured. Kaplan–Meier and log-rank analyses were used for time-to-event data. Cox regression was used for prognostic factors.

Results: Fifty-three patients were included; 16 (30.1%) treated with sunitinib and 37 (69.9%) with pazopanib. Forty-six (86.8%) patients had nccRCC and 7 (13.2%) had sRCC. The majority had intermediate or poor International Metastatic Renal-Cell Carcinoma Database Consortium risk (93%).

Median PFS was 6.6 months with sunitinib and 4.9 months with pazopanib (HR 1.75; P = 0.078). Treatment with pazopanib was associated with inferior OS in comparison with sunitinib (median OS: 30.4 months versus 8.7 months; HR 2.71, 95% CI 1.31–5.58, P = 0.007). These results were confirmed in subgroup analysis of patients with papillary, chromophobe and MiT family translocation histologies (median OS: 38.7 months versus 14.7 months; HR 3.16, 95% CI 1.20–8.29, P = 0.019). Unclassified and sarcomatoid histologies had inferior OS (median: 6.9 and 1.1 months, respectively) regardless of the treatment used.

Conclusion: In this patient cohort, pazopanib was associated with inferior OS in comparison with sunitinib for metastatic nccRCC. Larger trials are ideally warranted to confirm these results.

Keywords: non-clear cell, sarcomatoid, renal cell carcinoma, sunitinib, pazopanib

Loading Article Metrics ... Please wait

Related articles

Research: Socio-culturally mediated factors and lower level of education are the main influencers of functional cervical cancer literacy among women in Mayuge, Eastern Uganda

Abstract | Full Article | PDF Published: 21 Jan 2020 / https://doi.org/10.3332/ecancer.2020.1004

Research: High depletion of breast cancer cells from the peripheral blood with the method of non-specific separation

Abstract | Full Article | PDF Published: 21 Jan 2020 / https://doi.org/10.3332/ecancer.2020.1003

Case Report: VUS-type alteration in POLD1 and microsatellite instability in a metastatic luminal B breast cancer patient

Abstract | Full Article | PDF Published: 21 Jan 2020 / https://doi.org/10.3332/ecancer.2020.1002

Clinical Study: Computational analyses on genetic alterations in the NSD genes family and the implications for colorectal cancer development

Abstract | Full Article | PDF Published: 15 Jan 2020 / https://doi.org/10.3332/ecancer.2020.1001

Research: The clinical-care focused psychological interview (CLiC): a structured tool for the assessment of cancer patients’ needs

Abstract | Full Article | PDF Published: 13 Jan 2020 / https://doi.org/10.3332/ecancer.2020.1000



Founding partners

European Cancer Organisation European Institute of Oncology

Founding Charities

Foundazione Umberto Veronesi Fondazione IEO Swiss Bridge

Published by

ecancer Global Foundation