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Sunitinib treatment for patients with advanced clear-cell renal-cell carcinoma after progression on sorafenib

Kaja Zimmermann1, Alexander Schmittel, Ursula Steiner

  • 1Department of Medicine III (Hematology, Oncology and Transfusion Medicine), Charité, Campus Benjamin Franklin, Berlin, Germany. kaja.zimmermann@charite.de

Oncology
|March 27, 2009
PubMed
Abstract

Insights

Sequential sunitinib treatment in metastatic renal-cell carcinoma (RCC) patients progressing on sorafenib showed significant disease control. This suggests limited cross-resistance, making sunitinib a viable option after sorafenib failure in advanced RCC.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Sorafenib and sunitinib are tyrosine kinase inhibitors used for metastatic renal-cell carcinoma (RCC).
  • Their overlapping specificities raised questions about potential cross-resistance and the efficacy of sequential treatment.

Purpose of the Study:

  • To evaluate the efficacy of sequential sunitinib treatment in patients with metastatic RCC who progressed on sorafenib.
  • To determine if there is clinically significant cross-resistance between sorafenib and sunitinib.

Main Methods:

  • A cohort of 22 patients with metastatic RCC and disease progression after sorafenib were treated with sunitinib (50 mg for 4 weeks, followed by a 2-week break).
  • Response Evaluation Criteria in Solid Tumors (RECIST) criteria were used to assess treatment response every two cycles.

Main Results:

  • A disease control rate of 73% was achieved with sunitinib, including 18% partial responses (PR) and 55% stable disease (SD).
  • Median progression-free survival (PFS) on sunitinib was 21.5 weeks, with an estimated 1-year PFS of 31%.
  • Estimated 1-year overall survival (OS) was 60%, and no clear correlation was found between response to sorafenib and outcome on sunitinib.

Conclusions:

  • Second-line sunitinib demonstrated efficacy in patients with RCC progressing after initial sorafenib treatment.
  • The efficacy of sunitinib in this setting was comparable to first-line treatment results, indicating limited clinically relevant cross-resistance.

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