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Research paper
Early publication date: 2021-11-10
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Evaluation of the effectiveness and tolerability of sunitinib and pazopanib in the first line treatment of metastatic renal cell carcinoma

Senar Ebinç1, Ziya Kalkan1, Zeynep Oruç1, Zuhat Urakçı1, Mehmet Küçüköner1, Muhammet Ali Kaplan1, Abdurrahman Işıkdoğan1
DOI: 10.5603/OCP.2021.0033
Affiliations
  1. Dicle University Faculty of Medicine, Department of Medical Oncology, Diyarbakır, Turkey

open access

Ahead of print
ORIGINAL ARTICLES
Early publication date: 2021-11-10

Abstract

Introduction. It is known that sunitinib and pazopanib are effective in the first-line and subsequent treatment of metastatic renal cell carcinoma (mRCC). This study aims to investigate the effectiveness and tolerability of sunitinib and pazopanib in the first-line treatment of mRCC.

Material and methods. This study included 78 patients followed up in our clinic due to a diagnosis of mRCC, who received pazopanib or sunitinib treatment between 2006 and 2020. Along with clinical and laboratory findings, survival times obtained with each treatment and medication side effects were assessed. Sunitinib and pazopanib were compared in terms of effectiveness (ORR, PFS and OS) and tolerability.

Results. The patients’ median age at diagnosis was 55 years (25–81). In the first-line treatment, 54 patients (69.2%) received sunitinib and 24 (30.8%) received pazopanib. The comparison of sunitinib and pazopanib yielded an ORR of 66.7% vs. 45.8% (p = 0.08), PFS of 24 months vs. 19 months (p = 0.66) and OS of 27 months vs. 30 months (p = 0.73), respectively. The most common side effect was hypothyroidism in those on sunitinib (25.9%) and nausea-vomiting in those on pazopanib (41.7%). In our study, hemoglobin ≥ 13 g/dL, an ECOG PS of 0–1 and the occurrence of hypothyroidism as a medication side effect were found to be predictive factors of PFS for both agents. An International Metastatic RCC Database Consortium score corresponding to the poor risk group was associated with a poor PFS.

Conclusions. This study, which provides current real-world data, confirms that sunitinib and pazopanib have similar effectiveness and side-effect profiles in the first-line treatment of mRCC.

Abstract

Introduction. It is known that sunitinib and pazopanib are effective in the first-line and subsequent treatment of metastatic renal cell carcinoma (mRCC). This study aims to investigate the effectiveness and tolerability of sunitinib and pazopanib in the first-line treatment of mRCC.

Material and methods. This study included 78 patients followed up in our clinic due to a diagnosis of mRCC, who received pazopanib or sunitinib treatment between 2006 and 2020. Along with clinical and laboratory findings, survival times obtained with each treatment and medication side effects were assessed. Sunitinib and pazopanib were compared in terms of effectiveness (ORR, PFS and OS) and tolerability.

Results. The patients’ median age at diagnosis was 55 years (25–81). In the first-line treatment, 54 patients (69.2%) received sunitinib and 24 (30.8%) received pazopanib. The comparison of sunitinib and pazopanib yielded an ORR of 66.7% vs. 45.8% (p = 0.08), PFS of 24 months vs. 19 months (p = 0.66) and OS of 27 months vs. 30 months (p = 0.73), respectively. The most common side effect was hypothyroidism in those on sunitinib (25.9%) and nausea-vomiting in those on pazopanib (41.7%). In our study, hemoglobin ≥ 13 g/dL, an ECOG PS of 0–1 and the occurrence of hypothyroidism as a medication side effect were found to be predictive factors of PFS for both agents. An International Metastatic RCC Database Consortium score corresponding to the poor risk group was associated with a poor PFS.

Conclusions. This study, which provides current real-world data, confirms that sunitinib and pazopanib have similar effectiveness and side-effect profiles in the first-line treatment of mRCC.

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Keywords

renal cell carcinoma; sunitinib; pazopanib; VEGFR inhibitors

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About this article
Title

Evaluation of the effectiveness and tolerability of sunitinib and pazopanib in the first line treatment of metastatic renal cell carcinoma

Journal

Oncology in Clinical Practice

Issue

Ahead of print

Article type

Research paper

Early publication date

2021-11-10

DOI

10.5603/OCP.2021.0033

Keywords

renal cell carcinoma
sunitinib
pazopanib
VEGFR inhibitors

Authors

Senar Ebinç
Ziya Kalkan
Zeynep Oruç
Zuhat Urakçı
Mehmet Küçüköner
Muhammet Ali Kaplan
Abdurrahman Işıkdoğan

References (25)
  1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6): 394–424.
  2. Thompson RH, Ordonez MA, Iasonos A, et al. Renal cell carcinoma in young and old patients--is there a difference? J Urol. 2008; 180(4): 1262–6; discussion 1266.
  3. Vogelzang NJ, Priest ER, Borden L. Spontaneous regression of histologically proved pulmonary metastases from renal cell carcinoma: a case with 5-year followup. J Urol. 1992; 148(4): 1247–1248.
  4. Hofmann F, Hwang EuC, Lam TBl, et al. Targeted therapy for metastatic renal cell carcinoma. Cochrane Database Syst Rev. 2020; 10: CD012796.
  5. Zama IN, Hutson TE, Elson P, et al. Sunitinib rechallenge in metastatic renal cell carcinoma patients. Cancer. 2010; 116(23): 5400–5406.
  6. Bracarda S, Bellmunt J, Melichar B, et al. Overall survival in patients with metastatic renal cell carcinoma initially treated with bevacizumab plus interferon-α2a and subsequent therapy with tyrosine kinase inhibitors: a retrospective analysis of the phase III AVOREN trial. BJU Int. 2011; 107(2): 214–219.
  7. Mendel DB, Laird AD, Xin X, et al. In vivo antitumor activity of SU11248, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor and platelet-derived growth factor receptors: determination of a pharmacokinetic/pharmacodynamic relationship. Clin Cancer Res. 2003; 9(1): 327–337.
  8. Hutson T, Davis I, Machiels J, et al. Predictive and prognostic factors in phase II renal cell carcinoma trial with pazopanib (GW786034), a multi-kinase angiogenesis inhibitor. Ann Oncol. 2008(suppl 8): abstr 5780.
  9. Motzer RJ, Hutson TE, Tomczak P, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007; 356(2): 115–124.
  10. Motzer RJ, Hutson TE, Tomczak P, et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009; 27(22): 3584–3590.
  11. Sternberg CN, Davis ID, Mardiak J, et al. Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial. J Clin Oncol. 2010; 28(6): 1061–1068.
  12. Motzer RJ, Hutson TE, Cella D, et al. Pazopanib versus sunitinib in metastatic renal-cell carcinoma. N Engl J Med. 2013; 369(8): 722–731.
  13. Motzer R, Hutson T, McCann L, et al. Overall Survival in Renal-Cell Carcinoma with Pazopanib versus Sunitinib. N Engl J Med. 2014; 370(18): 1769–1770.
  14. Isik U, Kostek O, Demiray G, et al. Real life data from Turkey regarding the impact of first-line sunitinib and pazopanib in metastatic renal cell cancer. J Clin Oncol. 2019; 37(15_suppl): e16075–e16075.
  15. Motzer RJ, Bacik J, Murphy BA, et al. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol. 2002; 20(1): 289–296.
  16. Heng DYC, Xie W, Regan MM, et al. Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol. 2009; 27(34): 5794–5799.
  17. Patil S, Figlin RA, Hutson TE, et al. Prognostic factors for progression-free and overall survival with sunitinib targeted therapy and with cytokine as first-line therapy in patients with metastatic renal cell carcinoma. Ann Oncol. 2011; 22(2): 295–300.
  18. Cecere SC, Rossetti S, Cavaliere C, et al. Pazopanib in Metastatic Renal Cancer: A "Real-World" Experience at National Cancer Institute "Fondazione G. Pascale". Front Pharmacol. 2016; 7: 287.
  19. Wolter P, Stefan C, Decallonne B, et al. Evaluation of thyroid dysfunction as a candidate surrogate marker for efficacy of sunitinib in patients (pts) with advanced renal cell cancer (RCC). J Clin Oncol. 2008; 26(15_suppl): 5126–5126.
  20. Puzanov I, Michaelson MD, Cohen DP, et al. Evaluation of hand-foot syndrome (HFS) as a potential biomarker of sunitinib (SU) efficacy in patients (pts) with metastatic renal cell carcinoma (mRCC) and gastrointestinal stromal tumor (GIST). J Clin Oncol. 2011; 29(15_suppl): e21113–e21113.
  21. Larkin JMG, Pyle LM, Gore ME. Fatigue in renal cell carcinoma: the hidden burden of current targeted therapies. Oncologist. 2010; 15(11): 1135–1146.
  22. Méjean A, Ravaud A, Thezenas S, et al. Sunitinib Alone or after Nephrectomy in Metastatic Renal-Cell Carcinoma. N Engl J Med. 2018; 379(5): 417–427.
  23. Bex A, Mulders P, Jewett M, et al. Comparison of Immediate vs Deferred Cytoreductive Nephrectomy in Patients With Synchronous Metastatic Renal Cell Carcinoma Receiving Sunitinib: The SURTIME Randomized Clinical Trial. JAMA Oncol. 2019; 5(2): 164–170.
  24. Trump D, Escudier B, Porta C, et al. Randomized, controlled, double-blind, cross-over trial assessing treatment preference for pazopanib versus sunitinib in patients with metastatic renal cell carcinoma: PISCES Study. J Clin Oncol. 2014; 32(14): 1412–1418.
  25. Bracarda S, Iacovelli R, Boni L, et al. Rainbow Group. Sunitinib administered on 2/1 schedule in patients with metastatic renal cell carcinoma: the RAINBOW analysis. Ann Oncol. 2015; 26(10): 2107–2113.

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