TKIs safe, effective as first-line therapy in cytokine-intolerant metastatic renal cell cancer

Tyrosine kinase inhibitors (TKIs) are a safe and effective first-line treatment for metastatic renal cell cancer (mRCC), confirms a Turkey study. In addition, no significant difference has been observed among three TKI agents (sunitinib, pazopanib, and sorafenib) in terms of treatment duration, overall response rate (ORR), progression-free survival (PFS), and overall survival (OS).

This prospective, noninterventional, multicentre observational study evaluated TKI use in the treatment of cytokine-intolerant mRCC patients at 16 oncology centres across Turkey. A total of 151 mRCC patients (mean age 61.3 years, 74.8 percent males) treated with sunitinib, pazopanib, and sorafenib were included in the analysis.

The primary outcome measure was the data on duration of TKI treatment. Additionally, the authors recorded ORR, PFS, OS, and safety data.

Median treatment duration was 8.2 months, with a median follow-up of 17.9 months. ORR was 12.5 percent, while the rate of disease control was 70.8 percent.

Median PFS and OS were 7.5 months (95 percent confidence interval [CI], 6.4–10.4) and 27.3 months (95 percent CI, 17.6–27.3), respectively. Notably, there was no significant difference among the TKI agents used as regards treatment duration, ORR, PFS, and OS.

Diarrhoea (13.6 percent), asthenia (13.6 percent), and hand-foot syndrome (12.6 percent) were the most frequent adverse events. Of the patients, 30.5 percent needed dose modifications and 15 percent discontinued treatment due to toxicity.

“Cytokines have been the mainstay of treatment in mRCC for decades before the introduction of TKIs, which dramatically changed the therapeutic landscape in these patients,” the authors said.