Jose Manuel Ruiz-Morales1, Marcin Swierkowski2, J Connor Wells3, Anna Paola Fraccon4, Felice Pasini5, Frede Donskov6, Georg A Bjarnason7, Jae-Lyun Lee8, Hao-Wen Sim9, Andrzej Sliwczynsk10, Aneta Ptak-Chmielewska11, Zbigniew Teter12, Benoit Beuselinck13, Lori A Wood14, Takeshi Yuasa15, Carmel Pezaro16, Brian I Rini17, Cezary Szczylik2, Toni K Choueiri18, Daniel Y C Heng19. 1. Tom Baker Cancer Center, University of Calgary, Calgary, AB, Canada; Hospital Medica Sur, Mexico City, Mexico. 2. Department of Oncology, Military Institute of Medicine, Warsaw, Poland. 3. Tom Baker Cancer Center, University of Calgary, Calgary, AB, Canada. 4. Department of Oncology, Casa di Cura Pederzoli, Peschiera Del Garda, Italy. 5. Department of Medical Oncology, Ospedale Santa Maria della Misericordia, Rovigo, Italy. 6. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. 7. Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada. 8. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 9. Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada. 10. Department of Health Quality, Medical University of Lodz, Poland. 11. Institute of Statistics and Demography, Warsaw School of Economics, Warsaw, Poland. 12. National Health Fund, Warsaw, Poland. 13. Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium. 14. Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada. 15. Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan. 16. Monash University Eastern Health Clinical School, Australia. 17. Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA. 18. Dana-Farber Cancer Institute, Boston, MA, USA. 19. Tom Baker Cancer Center, University of Calgary, Calgary, AB, Canada. Electronic address: daniel.heng@albertahealthservices.ca.
Abstract
BACKGROUND: Sunitinib (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 METHODS: We 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. RESULTS: We 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). CONCLUSIONS: We 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.
BACKGROUND:Sunitinib (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 METHODS: We 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. RESULTS: We 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). CONCLUSIONS: We 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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Authors: M Neil Reaume; Naveen S Basappa; Lori Wood; Anil Kapoor; Georg A Bjarnason; Normand Blais; Rodney H Breau; Christina Canil; Patrick Cheung; Henry J Conter; Sebastien J Hotte; Claudio Jeldres; Michael A S Jewett; Pierre I Karakiewicz; Christian Kollmannsberger; Francois Patenaude; Alan So; Denis Soulières; Peter Venner; Phillippe Violette; Pawel Zalewski; Heather Chappell; Scott A North Journal: Can Urol Assoc J Date: 2017-10 Impact factor: 1.862
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