Alternating Treatment With Pazopanib and Everolimus vs Continuous Pazopanib to Delay Disease Progression in Patients With Metastatic Clear Cell Renal Cell Cancer

Abstract

clinicaltrials.gov Identifier: NCT01408004.

Role of immune checkpoint inhibitor-based therapies for metastatic renal cell carcinoma in the first-line setting: A Bayesian network analysis

“…The mean sample size was 218 patients per group (range 32–557), and seven RCTs having at least 100 patients per group. Twenty two trials were selected for clear-cell carcinoma subtypes [[11], [12], [13],[26], [27], [28], [29], [30], [31], [32], [33], [34]], and three trials also included small subsets of non-clear-cell histotypes, each comprising 4%–15% of the study population [[35], [36], [37]]. Details of RCT characteristics were summarized in Table 1.…”

“…In terms of PFS, 25 trials (11,771 patients) comparing 23 first-line systemic treatments were available for assessment [[11], [12], [13],[26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40], [41], [42], [43], [44], [45], [46], [47]]. According to the results, cabozantinib (HR: 0.66; 95% CrI: 0.46–0.94), nivolumab plus ipilimumab (HR: 0.82; 95% CrI: 0.68–0.99), pembrolizumab plus axitinib (HR: 0.69; 95% CrI: 0.57–0.84), avelumab plus axitinib (HR: 0.69; 95% CrI: 0.56–0.85), and atezolizumab plus bevacizumab (HR: 0.86; 95% CrI: 0.74–0.99) were statistically superior to sunitinib, while temsirolimus (HR: 1.38; 95% CrI: 1.03–1.85), everolimus (HR: 1.40; 95% CrI: 1.14–1.71), sorafenib (HR: 1.31; 95% CrI: 1.08–1.59), and IFN-α (HR: 1.68; 95% CrI: 1.44–1.96) were statistically inferior to sunitinib (Fig.…”

“…Toxicity of the treatments based on high-grade AEs within 20 RCTs (10,345 patients) were analyzed, and the results of comparisons caused by 20 systemic treatments are presented in Fig. 5 [[11], [12], [13],26,[28], [29], [30], [31], [32], [33], [34],[36], [37], [38],[44], [45], [46]]. Compared with sunitinib, atezolizumab (OR: 0.15; 95% CrI: 0.07–0.30), temsirolimus (OR: 0.24; 95% CrI: 0.09–0.69), nivolumab plus ipilimumab (OR: 0.50; 95% CrI: 0.28–0.84), atezolizumab plus bevacizumab (OR: 0.56; 95% CrI: 0.36–0.83), and sorafenib plus trebanbanib (OR: 0.32; 95% CrI: 0.10–0.97) were associated with significantly lower rate of high-grade AEs.…”

Gene Expression Difference Between Primary and Metastatic Renal Cell Carcinoma Using Patient-Derived Xenografts

“…Metastasis is one of the major pathogenic behaviors for almost all types of cancers [5], [6]. As a malignant tumor subtype, RCC metastasis has been widely identified in clinical practice [7], [8]. Generally, there are three major ways for cancer to metastasize and spread in the body: (1) direct spread into tissues around the primary situs (2) movement into the lymph system, and (3) movement into the bloodstream [9].…”

Sequential Treatment with Pazopanib and Everolimus in Metastatic Renal Cell Carcinoma

“…A median OS of 16 months and a median PFS of 5.7 months were achieved by everolimus or temsirolimus after progression with first-line pazopanib (Vogelzang et al, 2015). An alternating treatment with pazopanib and everolimus vs. continuous pazopanib was explored to delay the disease progression in naïve patients with mRCC; no significant differences in prolonged PFS, fewer toxic effects, or improved quality of life, were observed in the alternating treatment and the first-line treatment with a VEGF inhibitor remained the optimal approach in mRCC (Cirkel et al, 2016). …”