The effect of first targeted therapy on outcomes with second targeted therapy for metastatic renal cell carcinoma is not well known. The purpose of this study was to compare outcomes for patients receiving a second targeted therapy with everolimus by type of first targeted therapy.
Data were drawn from 3 separate retrospective chart reviews conducted in 2011, 2012, and 2014. Inclusion criteria and study design were similar across the 3 studies. To be included in this analysis, patients had to meet the following criteria: aged ≥ 18 years; received first targeted therapy with pazopanib, sunitinib, or sorafenib; and received second targeted therapy with everolimus. Overall survival, time to treatment failure, and time to treatment discontinuation outcomes were measured from second targeted therapy initiation. Outcomes were compared among treatment groups by Cox proportional hazard models adjusting for demographic and clinical characteristics. Hazard ratios for overall survival, time to treatment failure, and time to treatment discontinuation obtained from the 3 chart reviews were synthesized in meta-analyses.
Of 696 patients treated with everolimus as second targeted therapy, 605 patients received first targeted therapy with sunitinib/sorafenib and 91 with pazopanib. After synthesizing the hazard ratios from all studies in meta-analyses, there were no significant differences in study outcomes between patients receiving sunitinib/sorafenib versus those receiving pazopanib as first targeted therapy.
There were no significant differences among outcomes while receiving second targeted therapy with everolimus for patients treated with pazopanib versus sunitinib/sorafenib as first targeted therapy.
Clinical genitourinary cancer. 2015 Nov 19 [Epub ahead of print]
Sumanta K Pal, James E Signorovitch, William M Reichmann, Nanxin Li, Valerie Koo, Zhimei Liu, Jose Ricardo Perez, Nicholas J Vogelzang
City of Hope Comprehensive Cancer Center, Duarte, CA. , Analysis Group Inc, Boston, MA. Analysis Group Inc, Boston, MA. , Analysis Group Inc, Boston, MA. , Analysis Group Inc, Boston, MA. , Novartis Pharmaceuticals Corporation, East Hanover, NJ. , Novartis Pharmaceuticals Corporation, East Hanover, NJ. , US Oncology Research, Comprehensive Cancer Centers of Nevada, Las Vegas, NV.