Sunitinib versus sorafenib for patients with advanced renal cell carcinoma with renal impairment before the immune-oncology therapy era

Author:

Takayama Tatsuya1ORCID,Kubo Taro1,Yamazaki Masahiro1,Takeshima Saki1,Komatsubara Maiko1,Kameda Tomohiro1,Kamei Jun1,Sugihara Toru1,Fujisaki Akira1,Ando Satoshi1,Kurokawa Shinsuke1,Fujimura Tetsuya1

Affiliation:

1. Department of Urology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329--0498, Japan

Abstract

Abstract Objectives The efficacy and safety of sunitinib versus sorafenib in patients with advanced renal cell carcinoma with renal impairment remains poorly documented. Patients and methods We assessed the efficacy and safety of sunitinib and sorafenib in patients with advanced renal cell carcinoma with an estimated glomerular filtration rate of 15–60 mL/min/1.73 m2 by reviewing the medical records of patients treated at Jichi Medical University Hospital, Japan, between May 2008 and August 2016. Results Twenty-seven patients were treated with sunitinib and 14 with sorafenib. Median progression-free survival in sunitinib- and sorafenib-treated patients was comparable, at 6.6 vs 5.8 months, respectively (HR, 1.618; 95% CI, 0.689–3.798; P = 0.2691). Median overall survival was also comparable, at 65.9 vs 58.0 months (HR, 0.985; 95% CI, 0.389–2.479; P = 0.9748). Grade 3 or higher adverse events were significantly more frequent in the sunitinib-treated than sorafenib-treated patients (P = 0.0357). Compared to pre-treatment values, estimated glomerular filtration rate at the discontinuation of treatment was not decreased in either group. In contrast, estimated glomerular filtration rate was decreased on long-term treatment, particularly in previously nephrectomized patients. Conclusions Sunitinib and sorafenib had similar efficacy in patients with advanced renal cell carcinoma and severe renal impairment. Although renal function was not markedly impaired in either group, close attention to decreased renal function may be necessary in previously nephrectomized patients on long-term treatment.

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Radiology Nuclear Medicine and imaging,Oncology,General Medicine

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