Comparison of Axitinib and Everolimus in the Second Line Treatment of Metastatic Renal Cell Carcinoma Following Previous Treatment with a Tyrosine Kinase Inhibitor: a Multicentre Retrospective Analysis

Iqbal, Sahar; Badreldin, W.; Sundar, S; Thompson, Nicola; Tanguay, Jacob

doi:10.1016/j.clon.2015.12.022

Cited by 1 publication

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“…Everolimus and axitinib emerged as safe and effective second-line treatment options for mRCC patients after progression on VEGFtargeted therapy [14,20]. However, currently there is no clear guidance on the optimal choice of agents in the second and additional lines of therapy in mRCC, and evidence comparing different sequential regimens is limited to retrospective observational studies [21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Survival Benefits of Second-line Axitinib Versus Everolimus After First Line Sunitinib Treatment in Metastatic Renal Cell Carcinoma

Gergely

Bodoky

Rokszin³

et al. 2020

Pathol. Oncol. Res.

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Background Targeted therapies significantly improve clinical outcomes among patients with metastatic renal cell carcinoma (mRCC). Several new agents have been approved for first-and second-line use. However, there is a lack of compelling evidence comparing sequencing strategies, and available comparative data regarding the real-world effectiveness of different therapeutic sequences are limited. Materials and Methods We identified mRCC patients who initiated targeted therapy between January 1, 2008 and May 31, 2017 from the National Health Insurance Fund (NHIF) database of Hungary. Overall survival (OS) and duration of first-line treatment (DFT) were obtained for patients receiving sunitinib-everolimus, sunitinib-axitinib, or pazopanib-everolimus treatment sequences. OS of sunitinib-everolimus and sunitinib-axitinib sequences was also determined for patients having better or worse response to sunitinib first-line therapy. Results Median OS was significantly longer among patients treated with sunitinib-axitinib compared to those receiving sunitinibeverolimus. Median DFT was also significantly longer in the sunitinib-axitinib vs. sunitinib-everolimus group. Sunitinib-axitinib was associated with significantly longer median OS compared to sunitinib-everolimus in patients with better response to first-line sunitinib in the pooled sunitinib population. In patients with worse response to sunitinib, sunitinib-axitinib was associated with a trend towards greater OS compared to sunitinib-everolimus, but the difference did not reach statistical significance. Conclusions In this nationwide database analysis, mRCC patients treated with the sunitinib-axitinib sequence had significantly longer OS compared to those receiving sunitinib-everolimus therapy. The OS benefits of second-line axitinib were consistent among patients with better response to sunitinib defined by DFT values.

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