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Pazopanib: a Review in Advanced Renal Cell Carcinoma

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Abstract

Pazopanib (Votrient®), an orally administered multi-targeted tyrosine kinase inhibitor that predominantly inhibits vascular endothelial growth factor receptor-1, −2 and −3, platelet-derived growth factor receptor-α and -β, and the stem cell factor receptor c-Kit, is approved in the EU, the USA and other countries for the treatment of advanced renal cell carcinoma (RCC). In randomized controlled trials in patients with advanced, predominantly clear-cell RCC, pazopanib significantly improved progression-free survival (PFS) compared with placebo in both treatment-naïve and cytokine-pretreated patients and, as a first-line therapy, was noninferior to intermittent sunitinib with respect to PFS. However, pazopanib had a tolerability profile that was distinguishable from that of sunitinib, based on lower incidences of most adverse events, particularly those associated with discomfort, such as fatigue, hand-foot syndrome and stomatitis. Consistent with this, health-related quality of life (HR-QOL) measures evaluating fatigue, hand/foot soreness and mouth/throat soreness significantly favoured pazopanib over sunitinib. In addition, significantly more patients expressed a preference for pazopanib over sunitinib, primarily because of better overall HR-QOL and less fatigue. Efficacy and tolerability findings from these prospective clinical trials have been substantiated by evidence from a number of retrospective studies evaluating unselected real-world patients with metastatic RCC who received pazopanib (or sunitinib) as a first-line therapy. Thus, data from clinical trials supplemented with that from clinical practice support the use of pazopanib as a standard or alternative first-line treatment for advanced or metastatic RCC.

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Acknowledgements

During the peer review process, the manufacturer of pazopanib was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    James E. Frampton

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  1. James E. Frampton
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Correspondence to James E. Frampton.

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The preparation of this review was not supported by any external funding.

Conflicts of Interest

James Frampton is a salaried employee of Adis/Springer, is responsible for the article content and declares no relevant conflicts of interest.Additional information about this Adis Drug Review can be found at http://www.medengine.com/Redeem/E798F0600EAF9B8A

Additional information

The manuscript was reviewed by: A. Alva, Department of Internal Medicine, Haematology-Oncology, University of Michigan, Ann Arbour, MI, USA; M.W. Kattan, Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA; C.C. Porta, Division of Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy

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Frampton, J.E. Pazopanib: a Review in Advanced Renal Cell Carcinoma. Targ Oncol 12, 543–554 (2017). https://doi.org/10.1007/s11523-017-0511-8

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