Publication date: September 2016
Source:European Journal of Cancer, Volume 65
Author(s): Jose Manuel Ruiz-Morales, Marcin Swierkowski, J. Connor Wells, Anna Paola Fraccon, Felice Pasini, Frede Donskov, Georg A. Bjarnason, Jae-Lyun Lee, Hao-Wen Sim, Andrzej Sliwczynsk, Aneta Ptak-Chmielewska, Zbigniew Teter, Benoit Beuselinck, Lori A. Wood, Takeshi Yuasa, Carmel Pezaro, Brian I. Rini, Cezary Szczylik, Toni K. Choueiri, Daniel Y.C. Heng
BackgroundSunitinib (SU) and pazopanib (PZ) are standards of care for first-line treatment of metastatic renal cell carcinoma (mRCC). However, how the efficacy of these drugs translates into effectiveness on a population-based level is unknown.Patients and methodsWe used the International mRCC Database Consortium (IMDC) to assess overall survival (OS), progression-free survival (PFS), response rate (RR) and performed proportional hazard regression adjusting for IMDC prognostic groups. Second-line OS (OS2) and second-line PFS (PFS2) were also evaluated.ResultsWe obtained data from 7438 patients with mRCC treated with either first-line SU (n = 6519) or PZ (n = 919) with an overall median follow-up of 40.4 months (95% confidence interval [CI] 39.2–42.1). There were no significant differences in IMDC prognostic groups (p = 0.36). There was no OS difference between SU and PZ (22.3 versus 22.6 months, respectively, p = 0.65). When adjusted for IMDC criteria, the hazard ratio (HR) of death for PZ versus SU was 1.03 (95% CI 0.92–1.17, p = 0.58). There was no PFS difference between SU and PZ (8.4 versus 8.3 months, respectively, p = 0.17). When adjusted for IMDC criteria, the HR for PFS for PZ versus SU was 1.08 (95% CI 0.981–1.19, p = 0.12). There was no difference in RR between SU and PZ (30% versus 28%, respectively, p = 0.15). We also found no difference in any second-line treatment between either post-SU or post-PZ groups for OS2 (13.1 versus 11 months, p = 0.27) and PFS2 (3.7 versus 5.0 months, p = 0.07).ConclusionsWe confirmed in real-world practice that SU and PZ have similar efficacy in the first-line setting for mRCC and do not affect outcomes with subsequent second-line treatment.
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