Objective: To compare outcomes of metastatic renal cell carcinoma (mRCC) patients treated with everolimus, temsirolimus, and sorafenib following initial treatment with a tyrosine kinase inhibitor (TKI) in community and academic practices throughout the US.
Research Design and Methods: Medical records of mRCC patients who received everolimus, temsirolimus or sorafenib as their second therapy following a TKI were retrospectively reviewed from a nationally representative panel of oncologists. Overall survival (OS) and progression-free survival (PFS) of second targeted therapies were compared using multivariable Cox proportional hazard models, with adjustment for demographics, disease severity and prior treatments.
Results: A total of 233, 178, and 123 mRCC patients receiving everolimus, temsirolimus, and sorafenib, respectively, as second targeted therapies were included. Eighty-six percent used sunitinib and the remainder used sorafenib or pazopanib as their initial TKI. After adjusting for baseline characteristics, everolimus was associated with significantly prolonged OS (hazard ratio [HR] 0.60; CI 0.42-0.85; p=0.004) and PFS (HR 0.73; CI 0.54-0.97; p=0.032) compared to temsirolimus. Everolimus was associated with significantly longer OS (HR 0.66; CI 0.44-0.99; p=0.045) and numerically longer PFS compared to sorafenib. No significant differences were observed between temsirolimus and sorafenib.
Limitations: Despite adjustment for multiple patient characteristics, comparisons between treatment groups may be confounded by unobserved factors in this retrospective observational study. Tolerability outcomes were not collected.
Conclusions: In this retrospective, non-randomized study of mRCC patients with prior TKI treatment, everolimus was associated with significantly prolonged OS and PFS compared to temsirolimus and significantly prolonged OS compared to sorafenib.
Written by:
Wong MK, Yang H, Signorovitch JE, Wang X, Liu Z, Liu NS, Qi CZ, George DJ. Are you the author?
Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
Reference: Curr Med Res Opin. 2013 Dec 12. Epub ahead of print.
doi: 10.1185/03007995.2013.871243
PubMed Abstract
PMID: 24329572
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