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Pazopanib versus sunitinib for the treatment of metastatic renal cell carcinoma patients with poor-risk features

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Abstract

Purpose

With the exception of temsirolimus, clinical trials in metastatic renal cell carcinoma (mRCC) with poor-risk features are lacking. We previously showed that vascular endothelial growth factor receptor tyrosine kinase inhibitors are active and well tolerated by poor-risk group. This study evaluated and compared the efficacy and safety of pazopanib and sunitinib in this group.

Methods

We reviewed the medical records of all patients with mRCC who had received pazopanib or sunitinib at Asan Medical Center. We only assessed patients who had three or more poor-risk features as determined in the advanced renal cell carcinoma trial.

Results

Between December 2006 and April 2015, a total of 172 patients who met the inclusion criteria received pazopanib (n = 72) or sunitinib (n = 100). The clinical characteristics were as follows in the pazopanib/sunitinib groups: median age = 60/57 years (range 34–80/17–83); clear cell type = 65/80 (90/80 %); and prior nephrectomy = 46/56 (64/56 %). The disease control rates in the pazopanib/sunitinib groups were 82/60 % (p = 0.002). With a median follow-up duration of 14.2 months (range 1.6–65.0), the median overall survival and progression-free survival in the pazopanib/sunitinib groups were 14.4/8.9 (p = 0.030) and 9.8/4.3 months (p = 0.040), respectively. The common all-grade toxicities for pazopanib/sunitinib were anemia (32 vs. 77 %), neutropenia (33 vs. 56 %), increased aspartate aminotransferase or alanine aminotransferase levels (36 vs. 35 %), fatigue (38 vs. 55 %), and hand–foot syndrome (17 vs. 51 %).

Conclusions

Pazopanib and sunitinib are both active and well tolerated in mRCC patients with poor-risk features, but pazopanib might be more effective in this group.

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Acknowledgments

This study was presented in part at the 7th European Multidisciplinary Meeting on Urologic Cancers, November 12–15, 2015, in Barcelona, Spain.

Funding

This study was supported by a grant (HI12C1788, HI14C1931, HI14C1731) from the Korean Health Technology R&D Project, Ministry of Health and Welfare, Korea.

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Authors and Affiliations

  1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jwa Hoon Kim & Jae Lyun Lee

  2. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-gu, Seoul, 05505, Korea

    Inkeun Park & Jae Lyun Lee

  3. Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea

    Inkeun Park

Authors
  1. Jwa Hoon Kim
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  2. Inkeun Park
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Correspondence to Jae Lyun Lee.

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Conflict of interest

J. L. Lee received speaker honoraria from Astellas, Novartis, and Pfizer, and research funding from Bayer, Exelixis, Janssen, Novartis, and Pfizer. J. H. Kim and I. Park declare that they had no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Institutional Review Board of Asan Medical Center and with the 1964 Helsinki Declaration and its later amendments. For retrospective design of the current study, formal informed consent was not required.

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Kim, J.H., Park, I. & Lee, J.L. Pazopanib versus sunitinib for the treatment of metastatic renal cell carcinoma patients with poor-risk features. Cancer Chemother Pharmacol 78, 325–332 (2016). https://doi.org/10.1007/s00280-016-3093-8

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  • DOI: https://doi.org/10.1007/s00280-016-3093-8

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