Outcomes of Unselected Patients with Metastatic Clear-Cell Renal Cell Carcinoma Treated with Front-Line Pazopanib Therapy Followed by Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitors (VEGFR-TKI) or Mammalian Target of Rapamycin Inhib

BACKGROUND - Data regarding unselected patients with metastatic clear-cell renal cell carcinoma (ccRCC) treated with first-line pazopanib are limited.

PATIENTS AND METHODS - We reviewed records of patients with metastatic ccRCC treated with first-line pazopanib during 11/09-11/12.

Cox models were fitted to evaluate the association of progression-free survival (PFS) and overall survival (OS) with patient co-variables.

RESULTS - Eighty-eight patients were identified; 74 were evaluable for response: 2 (3%) had complete response, 27 (36%) had partial response, 36 (49%) had stable disease, and 9 (12%) had progressive disease. Median PFS was 13. 7 months (95% CI: 8. 7 - 18. 3). PFS was correlated with Karnofsky performance score < 80 (HR = 3. 26, p < 0. 0001) and serum lactate dehydrogenase >1. 5 ULN (HR = 3. 25, p = 0. 0135). Median OS was 29. 1 months (95% CI: 20. 2 - NA). OS was correlated with brain metastasis (HR = 2. 55, p = 0. 0089), neutrophilia (HR = 1. 179, p = 0. 0178), and anemia (HR = 3. 51, p = 0. 0001). No treatment-related deaths occurred. Fifty-three patients received second-line therapy (VEGFR-TKI [22], mTORi [22], others [9]); median PFS was 8. 6 months (95% CI: 3. 3 - 25. 7) with VEGFR-TKI and 5 months (95% CI: 3. 5 - 15. 2) with mTORi, p = 0. 41; median OS was 19. 9 months (95% CI: 12. 9 - NA) and 14. 2 months (95% CI: 8. 1 - NA), from initiation of second-line VEGFR-TKI or mTORi, respectively, p = 0. 37.

CONCLUSIONS - In this retrospective study, first-line pazopanib confirmed its efficacy in metastatic ccRCC. Trends for longer PFS and OS were observed with VEGFR-TKI than mTORi after first-line pazopanib. This article is protected by copyright. All rights reserved.

BJU international. 2015 Nov 17 [Epub ahead of print]

Marc R Matrana, Tharakeswara Bathala, Matthew T Campbell, Cihan Duran, Aditya Shetty, Purnima Teegavarapu, Sarathi Kalra, Lianchun Xiao, Bradley Atkinson, Paul Corn, Eric Jonasch, Nizar M Tannir

Division of Cancer Medicine The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Division of Cancer Medicine The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Division of Cancer Medicine The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Division of Quantitative Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Clinical Pharmacy Programs, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

PubMed

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