First-line PAzopanib in NOn-clear cell Renal cArcinoMA: the Italian retrospective multicenter PANORAMA study

Background

Pazopanib is a standard first line treatment for metastatic clear cell renal cell carcinoma (RCC). Very few data on its activity in non-clear cell RCC (nccRCC) are currently available in the literature. We retrospectively analyzed efficacy and toxicity of Pazopanib in an Italian multicenter cohort of nccRCC patients.

Methods

Records from nccRCC patients treated with first line Pazopanib were reviewed and collected. Response rate (RR), progression free survival (PFS), and overall survival (OS) were evaluated in this cohort. Univariate analysis were conducted to correlate clinicopathological factors with outcome. Descriptive analysis of patients and diseases characteristics were also performed.

Results

Between 2010 and 2015, 37 patients with nccRCC were treated with Pazopanib as first line therapy at 17 Italian centers. 24% had chromophobe histology, 51% papillary, 22% unclassified and 3% had Xp11 translocation. Motzer and Heng risk were good in 22% and 24%, intermediate in 68% and 49% and poor in 10% and 22% of patients respectively. 76% had nephrectomy. 57% had ECOG performance status (PS) = 0, 27% PS = 1 and 16% PS = 2-3. 22% had a basal neutrophil to lymphocyte ratio (NLR) ≥ 3. Dose reductions/interruptions of Pazopanib for toxicity were required in 46% of cases; G3-4 toxicity occurred in 32% of patients, G1-2 in 89%. 81% achieved clinical benefit (partial response or stable disease), while 16% had disease progression as best response. Median PFS (38% censored) and OS (46% censored) were 15.9 [95%CI 5.9–25.8] and 17.3 [95%CI 11.5-23.0] months, respectively. At the univariate analysis, factors associated with PFS were nephrectomy (p = 0.02), Motzer score (p 

Conclusions

In nccRCC patients, treatment with Pazopanib demonstrated to be effective and feasible, despite dose reductions often required for toxicity in this population.

Clinical trial identification

not applicable

Legal entity responsible for the study

Santa Chiara Hospital, Trento.

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.