Sunitinib followed by sorafenib or vice versa for metastatic renal cell carcinoma – data from the Czech registry

Konference: 2010 35th Congress ESMO – účast ČR

Kategorie: Genitourinární nádory

Téma: Genitourinary tumors

Číslo abstraktu: 0940

Autoři: Doc. MUDr. Tomáš Büchler, Ph.D.; Mgr. Michal Štícha; prof. MUDr. Bohuslav Melichar, Ph.D.; prof. MUDr. Rostislav Vyzula, CSc.; prof. MUDr. Jitka Abrahámová, DrSc.

Background: Sequential therapy with tyrosine kinase inhibitors (TKIs) sunitinib and sorafenib is a very common treatment choice for patients with advanced/metastatic renal cell carcinoma (mRCC). The aim of this retrospective, register-based study was to analyse the outcomes of RCC patients treated with sunitinib-sorafenib or sorafenib-sunitinib sequence.

Patients and methods: Data on mRCC patients treated with either sunitinib-sorafenib or sorafenib-sunitinib sequence were obtained from the Czech Clinical Registry of Renal Cell Cancer Patients (RENIS), a database of patients treated with TKIs, and analysed retrospectively. We have included all patients treated between May 2006 and September 2009.

Results: We have identified 119 patients with clear-cell mRCC treated with both sunitinib and sorafenib, including 64 patients treated with sunitinib-sorafenib sequence and 55 patients treated with sorafenib-sunitinib sequence. The baseline characteristics were well-balanced between the two groups. Median time from the onset of TKI therapy to progression on the second TKI (PFS) was 14.5 months for patients treated with sunitinib-sorafenib sequence and 18.0 months for those receiving sorafenib followed by sunitinib (p=0.55). Overall survival (OS) at 1 year was 80.3% for patients treated with sunitinib-sorafenib and 81.1% for sorafenib-sunitinib patients (p=0.65). Treatment toxicities were consistent with registration trials, but a significant proportion of patients have switched between TKIs or discontinued TKI therapy because of toxicity.

Conclusion: PFS difference between the cohorts was not significant in the present study. The OS data are still immature. Despite the lack of statistical significance, there is a trend to improved survival for patients treated with sorafenib-sunitinib sequence who have a follow-up longer than 1 year.
Treatment N Median PFS, Month OS at 1 year, % (95% CI)
Sutent-->Nexavar 64 14.5 80.3 (69.8; 90.8)
Nexavar-->Sutent 55 18.0 81.1 (70.5; 91.7)

Disclosure: B. Melichar: Speakers honoraria from Roche, Bayer, and Novartis.
All other authors have declared no conflicts of interest.

Datum přednesení příspěvku: 9. 9. 2010