Pazopanib as a possible option for the treatment of metastatic non-clear cell renal carcinoma patients: a systematic review

Abstract

Background: Effective systemic treatment of non-clear cell renal carcinoma (nccRCC) is still an unmet clinical need, with few studies to support an evidence-based approach. To date, the only recommended standard first-line treatment is sunitinib. Pazopanib may also be used in nccRCC but its place in therapy is not clearly established. It has comparable efficacy and better tolerability than sunitinib in clear cell renal carcinoma. Our objective was to review the use of pazopanib in metastatic nccRCC. Methods: We conducted a systematic review according to PRISMA guidelines. Any type of study reporting the use of pazopanib in metastatic renal cell carcinoma including cases with non-clear cell histology was eligible. Results: In all, 15 studies were included in our analysis, including a total of 318 nccRCC patients treated with pazopanib. Most studies were retrospective ( n = 12); three were prospective trials. The specific outcomes of nccRCC patients were reported by four studies. Pazopanib alone as first-line treatment gave overall response rates ranging from 27% to 33%, disease control rates of 81–89%, median progression free survival of 8.1–16.5 months and median overall survival of 17.3–31.0 months. Grade 3–4 adverse events rates were 21–55%. Conclusion: The present review provides for the first time a systematic summary of evidence about the possible use of pazopanib as first-line treatment for nccRCC, with a favorable outcome despite the low strength of evidence. Pazopanib could be considered as a possible therapeutic option in this setting.

Effects of BAP1, Ki-67 index, and Id-1 in patients with clear cell renal carcinoma and their correlation with clinical features and prognosis

“…Id-1 positive Id-1 negative Id-1 positive-rechecked Id-1 negative-rechecked cells, Ki-67 is a sign of the late-stage cell cycle. The mRNA level of Ki-67 is highest around the G2 phase, while its protein level increases throughout the cell cycle and reaches a peak during mitosis (11). At the same time, ki-67 was found to play a key role in mitosis by regulating recombinant chromatin, promoting epithelial mesenchymal transformation and thus inducing the occurrence and development of CCRCC.…”

Advances in non‐clear cell renal cell carcinoma management: From heterogeneous biology to treatment options

“…[58][59][60][61][62] The trials found pazopanib to be well tolerated overall; however, CTCAE grade 3 adverse events were reported in 20% to 55% of patients, the most common being fatigue, diarrhea and hypertension. [58][59][60]63 However, interestingly, in a retrospective cohort study of patients with metastatic nccRCC treated with pazopanib or sunitinib, pazopanib was associated with inferior OS. 64 Thus, while TKI monotherapy has shown some clinical efficacy in nccRCC subtypes, there is much room for improvement.…”

Analgesic efficacy and safety of nalbuphine versus morphine for perioperative tumor ablation: a randomized, controlled, multicenter trial

“…Tumor ablation is a common non-vascular interventional tumor therapy and has been recommended by several guidelines for treating diverse solid tumors, for example, liver cancer and lung cancer [7][8][9][10][11][12][13][14]. The guidelines for the treatment of liver cancer recommend radiofrequency, cryotherapy, absolute alcohol injection, and microwave ablation (MWA) as local therapies [8].…”