Efficacy of First-Line Targeted Therapy in Real-World Korean Patients with Metastatic Renal Cell Carcinoma: Focus on Sunitinib and Pazopanib.

To evaluate survival outcomes and prognostic factors for overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) who received sunitinib (SU) and pazopanib (PZ) as first-line therapy in real-world Korean clinical practice.

Data of 554 patients with mRCC who received SU or PZ at eight institutions between 2012 and 2016 were retrospectively reviewed. Based on the targeted therapy, the patients were divided into SU (n = 293) or PZ (n = 261) groups, and the clinicopathological variables and survival rates of the two groups were compared. A multivariable Cox proportional hazard model was used to determine the prognostic factors for OS.

The median follow-up was 16.4 months (interquartile range, 8.3-31.3). Patients in the PZ group were older, and no significant difference was observed in the performance status (PS) between the two groups. In the SU group, the dose reduction rate was higher and the incidence of grade 3 toxicity was more frequent. The objective response rates were comparable between the two groups (SU, 32.1% vs. PZ, 36.4%). OS did not differ significantly between the two groups (SU, 36.5 months vs. PZ, 40.2 months; log-rank, P = 0.955). Body mass index, Eastern Cooperative Oncology Group PS > 2, synchronous metastasis, poor Heng risk criteria, and liver and bone metastases were associated with a shorter OS.

Our real-world data of Korean patients with mRCC suggested that SU and PZ had similar efficacies as first-line therapy for mRCC. However, PZ was better tolerated than SU in Korean patients.

Journal of Korean medical science. 2018 Nov 22*** epublish ***

Myung Soo Kim, Ho Seok Chung, Eu Chang Hwang, Seung Il Jung, Dong Deuk Kwon, Jun Eul Hwang, Woo Kyun Bae, Jae Young Park, Chang Wook Jeong, Cheol Kwak, Cheryn Song, Seong Il Seo, Seok-Soo Byun, Sung-Hoo Hong, Jinsoo Chung

Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea., Department of Hemato-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea., Department of Urology, Korea University Ansan Hospital, Ansan, Korea., Department of Urology, Seoul National University Hospital, Seoul, Korea., Department of Urology, Asan Medical Center, Seoul, Korea., Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea., Department of Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea., Department of Urology, National Cancer Center, Goyang, Korea.