872 - Comparative efficacy of sunitinib versus sorafenib as the first-line treatment for patients with metastatic renal cell carcinoma

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Renal Cell Cancer
Presenter Seong Joon Park
Authors S.J. Park1, J. Lee2, I. Park3, K. Park2, J. Ahn2, D.H. Lee4, C. Song5, J.H. Hong5, C. Kim5, H. Ahn5
  • 1Oncology, Asan Medical Center, 138-736 - Seoul/KR
  • 2Department Of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR
  • 3Oncology, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR
  • 4Division Of Oncology, Dept Of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR
  • 5Department Of Urology, Asan Medical Center, University of Ulsan College of Medicine, 138-736 - Seoul/KR

Abstract

Background

Sunitinib has been recommended as the primary treatment in the patients with metastatic renal cell carcinoma (mRCC) among the vascular endothelial growth factor tyrosine kinase inhibitor (VEGF TKI). However, there are no published clinical data that compared directly the efficacy of targeted agents in the first line setting. This study investigated the efficacy and toxicity of sorafenib and sunitinib as primary treatment for patients with mRCC.

Methods

To compare the efficacy and toxicities between sorafenib and sunitinb, clinical database was used to identify all patients with mRCC treated with VEGF TKIs in Asan Medical Center from April 2005 to March 2011. Among 304 patients, we identified 49 and 220 patients who were treated first with sorafenib and sunitinib, respectively.

Results

The patients in the sorafenib group were older than those in the sunitinib group (62 vs 56.5 years, p = 0.019). Disease control rate (DCR) of 71% and 74% were achieved in sorafenib and sunitinib groups, respectively (p = 0.687). After a median follow-up duration of 27.6 months, progression free survival (PFS), time to treatment failure (TTF), and overall survival (OS) were not significantly different between the groups (sorafenib vs. sunitinib, PFS 8.6 months vs. 9.9 months, p = 0.948; TTF 6.6 months vs. 7.2 months, p = 0.665; OS; 25.7 months vs. 22.6 months, p = 0.774). Patients treated with sorafenib required dose reduction due to toxicities less frequently than those treated with sunitinib (37% vs. 54%, p = 0.034). Haematological toxicities of grade 3 or 4 were more common in the sunitinib group than in the sorafenib group (45% vs. 4%, p < 0.001), as was grade 3 or 4 hypertension although this was not statistically significant (14% vs. 4%, p = 0.066). Age (>60 years), duration from diagnosis to treatment (<1 year), anemia, neutrophilia, thorombocytosis, and bone and liver metastases were independent prognostic factors affecting OS. Multivariate analysis showed that first-line VEGF TKI did not affect OS (hazard ratio sorafenib vs. sunitinib = 0.94, p = 0.774)

Conclusion

Sorafenib showed comparable efficacy to sunitinb and demonstrated fewer and less severe toxicities in the treatment of mRCC patients.

Disclosure

All authors have declared no conflicts of interest.