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  • Title: Pazopanib versus sunitinib for the treatment of metastatic renal cell carcinoma patients with poor-risk features.
    Author: Kim JH, Park I, Lee JL.
    Journal: Cancer Chemother Pharmacol; 2016 Aug; 78(2):325-32. PubMed ID: 27324136.
    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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