Objective response and time to progression on sequential treatment with sunitinib and sorafenib in metastatic renal cell carcinoma
- 274 Downloads
Patients with metastatic renal cell carcinoma (mRCC) are often treated sequentially with targeted agents, although the optimal strategy is not known. A retrospective, registry-based study has been carried out to assess correlation between clinical response and progression-free survival in patients with mRCC treated sequentially with tyrosine-kinase inhibitors (TKIs) sunitinib and sorafenib. Data on 218 mRCC patients treated with sunitinib and sorafenib who completed therapy with both TKIs were obtained from a database of mRCC patients. Standard nonparametric methods were used to assess correlation between response, PFS and length of treatment on the two agents. A strong correlation between responses to first- versus second TKI was observed (p < 0.001). No significant association was noted between the duration of therapy with the two TKIs (p = 0.056), although there was a weak statistically significant correlation between progression-free survival times in the subgroup patients who discontinued treatment because of disease progression. In conclusion, the duration of response on first TKI is of limited value in selecting mRCC patients for sequential TKI therapy. There is a strong correlation between the types of tumour response on the first- versus the second TKI.
KeywordsSunitinib Sorafenib Renal cell carcinoma Response
The RENIS database is maintained with partial support by Pfizer and Bayer Schering Pharma, the manufacturers of sunitinib and sorafenib, respectively.
Conflict of interest
TB and BM have received honoraria for lectures from Pfizer and Bayer Schering Pharma.
- 1.Motzer RJ, Escudier B, Oudard S, Hutson TE, Porta C, Bracarda S, Grünwald V, Thompson JA, Figlin RA, Hollaender N, Urbanowitz G, Berg WJ, Kay A, Lebwohl D, Ravaud A. Efficacy of everolimus in advanced renal cell carcinoma: a double-blind, randomised, placebo-controlled phase III trial. Lancet. 2008;372:449–56.PubMedCrossRefGoogle Scholar
- 2.Rini BI, Escudier B, Tomczak P, Kaprin A, Szczylik C, Hutson TE, Michaelson MD, Gorbunova VA, Gore ME, Rusakov IG, Negrier S, Ou YC, Castellano D, Lim HY, Uemura H, Tarazi J, Cella D, Chen C, Rosbrook B, Kim S, Motzer RJ. Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): a randomised phase 3 trial. Lancet. 2011;378:1931–9.PubMedCrossRefGoogle Scholar
- 6.Al-Marrawi MY, Rini BI, Harshman LC, Bjarnason GA, Wood L, Vaishampayan UN, MacKenzie MJ, Knox JJ, Agarwal N, Kollmannsberger CK, Tan M, Rha SY, Donskov F, North SA, Choueiri TK, Heng DYC. The association of clinical outcome to front-line VEGF-targeted therapy with clinical outcome to second-line VEGF-targeted therapy in metastatic renal cell carcinoma (mRCC) patients (Pts). J Clin Oncol. 2011; 29 (suppl; abstr 4555).Google Scholar
- 7.Escudier B, Loomis AK, Kaprin A, Motzer R, Tomczak P, Tarazi J, Kim S, Gao F, Williams JA, Rini B. Association of single nucleotide polymorphisms (SNPs) in VEGF pathway genes with progression-free survival (PFS) and blood pressure (BP) in metastatic renal cell carcinoma (mRCC) in the phase 3 trial of axitinib versus sorafenib (AXIS trial). Eur J Cancer. 2011;47(Suppl 1):S505.CrossRefGoogle Scholar