158007-172

First-line sunitinib versus pazopanib in metastatic renal cell carcinoma (mRCC): Results from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC).

Subcategory: 
Category: 
Genitourinary Cancer
Session Type and Session Title: 
Poster Session C: Renal Cell Cancer
Abstract Number: 

544

Poster Board Number: 
Poster Session C Board #F5
Citation: 
J Clin Oncol 34, 2016 (suppl 2S; abstr 544)
Author(s): 
Jose Manuel Ruiz Morales, J Connor Wells, Frede Donskov, Georg A. Bjarnason, Jae-Lyun Lee, Jennifer J. Knox, Benoit Beuselinck, Ulka N. Vaishampayan, James Brugarolas, Reuben James Broom, Aristotelis Bamias, Takeshi Yuasa, Sandhya Srinivas, D. Scott Ernst, Carmel Jo Pezaro, Lori Wood, Christian K. Kollmannsberger, Brian I. Rini, Toni K. Choueiri, Daniel Yick Chin Heng; Tom Baker Cancer Centre - University of Calgary, Calgary, AB, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Karmanos Cancer Institute, Wayne State University, Detroit, MI; The University of Texas Southwestern Medical Center, Dallas, TX; Auckland City Hospital, Auckland, New Zealand; Dept of Clinical Therapeutics, University of Athens, Athens, Greece; Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Stanford University Medical Center, Stanford, CA; London Regional Cancer Centre, London, ON, Canada; The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom; Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada; BC Cancer Agency, Vancouver Cancer Centre, Vancouver, BC, Canada; Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Dana-Farber Cancer Institute, Boston, MA; Tom Baker Cancer Center, University of Calgary, Calgary, AB, Canada

Abstract Disclosures

Abstract: 

Background: Sunitinib (SU) and Pazopanib (PZ) have been compared head-to-head in the first-line phase III COMPARZ study in metastatic renal cell carcinoma (mRCC). We compared SU versus PZ, to confirm outcomes and subsequent second-line therapy efficacy in a population-based setting. Methods: We used the IMDC to assess overall survival (OS), progression-free survival (PFS), response rate (RR) and performed proportional hazard regression adjusting for IMDC prognostic groups. Second-line OS2 and PFS2 were also evaluated. Results: We obtained data from 3,606 patients with mRCC treated with either first line SU (n=3226) or PZ (n=380) with an overall median follow-up of 43.5 months (m) (CI95% 41.4 – 46.4). IMDC risk group distribution for favorable prognosis was 440 (17.3%) for SU vs 72 (25%) for PZ, intermediate prognosis 1414 (55.6%) for SU vs 153 (53%) for PZ, poor prognosis 689 (27.1%) for SU vs 62 (22%) for PZ, p= 0.0027. We found no difference between SU vs. PZ for OS (20.1 [CI95% 18.76-21.42] vs. 23.68 m [CI95% 19.54 - 28.81] p=0.19), PFS (7.22 [CI95% 6.76 - 7.78] vs. 6.83 m [CI95% 5.58 - 8.27] p=0.49). The RR was similar in both groups (Table 1). Adjusted HR for OS and PFS were 0.952 (CI95% 0.788 – 1.150 p=0.61) and 1.052 (CI95% 0.908 – 1.220 p = 0.49), respectively. We also found no difference in any second-line treatment between either post-SU vs. post-PZ groups for OS2 (12.88 [CI95% 11.89 – 14.19] vs. 12.91 m [CI95% 10.3 – 19.1] p=0.47) and PFS2 (3.67 [CI95% 3.38 – 3.87] vs. 4.53 m [CI95% 3.08 – 5.35] p=0.4). There was no statistical difference in OS2 and PFS2 if everolimus was used after SU or PZ (p = 0.33 and p = 0.41, respectively) or if axitinib was used after SU or PZ (p = 0.73 and p = 0.72, respectively). Conclusions: We confirmed in real world practice, that SU and PZ have similar efficacy in the first-line setting for mRCC and do not affect outcomes with subsequent second-line treatment.

Response rate.

Complete
response
Partial
response
Stable
disease
Progressive
disease
Not
evaluated
SU62 (2.3%)760 (28%)1206 (44.58%)677 (25%)35
PZ4 (1.4%)69 (24.3%)149 (52.5%)62 (21.8%)21

Fisher’s exact test = 0.0909.