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Updated: May 21, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Second-line treatment outcomes after first-line sunitinib therapy in metastatic renal cell carcinoma
Chi-Chang Chen1, Gregory P Hess, Zhimei Liu
1Health Economics and Outcomes Research, IMS Health, Plymouth Meeting, PA, USA. c.chen@us.imshealth.com
Abstract:
This study was conducted to evaluate the treatment outcomes associated with common second-line targeted therapies given after first-line sunitinib for metastatic renal cell carcinoma (mRCC). The sample comprised patients with mRCC (n = 257) who were receiving second-line everolimus, sorafenib, or temsirolimus between April 1, 2008, and February 29, 2011, after first-line sunitinib treatment. The patients were followed-up from the start of second-line treatment until treatment failure (defined as advancement to a third-line therapy or to mortality) or the last observation in the medical and pharmacy databases. Treatment failure was observed in 38.5% (n = 99) of cases: 20.2% of patients (n = 52) advanced a line of treatment; and 18.3% of patients (n = 47) died. Kaplan-Meier analysis indicated a statistical difference in time to treatment failure among the 3 second-line targeted therapies (log-rank test, P = .045). The estimated 1-year cumulative probabilities of treatment failure were 49.9% for everolimus, 68.4% for sorafenib, and 71.4% for temsirolimus. In a multivariate Cox proportional hazards model, a higher adjusted risk of treatment failure vs. everolimus was observed for both temsirolimus (hazard ratio [HR] 2.05 [95% CI, 1.26-3.35]; P = .004) and sorafenib (HR 1.77 [95% CI, 1.02-3.07]; P = .043). The results of this real-world data analysis suggest that the risk of second-line treatment failure after first-line sunitinib was significantly higher with temsirolimus and sorafenib compared with everolimus.
Insights
Everolimus showed a lower risk of treatment failure compared to sorafenib and temsirolimus as a second-line therapy for metastatic renal cell carcinoma (mRCC) after initial sunitinib treatment.
Area of Science:
- Oncology
- Pharmacology
- Clinical Medicine
Background:
- Metastatic renal cell carcinoma (mRCC) treatment often involves sequential targeted therapies.
- Sunitinib is a common first-line treatment for mRCC.
- Evaluating second-line therapies after sunitinib is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare treatment outcomes of second-line targeted therapies (everolimus, sorafenib, temsirolimus) following first-line sunitinib in mRCC patients.
- To assess the time to treatment failure and associated risks for these therapies.
Main Methods:
- Retrospective analysis of 257 mRCC patients receiving second-line therapy (everolimus, sorafenib, or temsirolimus) after sunitinib.
- Follow-up until treatment failure (progression or mortality) or last observation.
- Kaplan-Meier analysis and multivariate Cox proportional hazards modeling were used.
Main Results:
- A statistically significant difference in time to treatment failure was observed among the three second-line therapies (P = .045).
- Everolimus demonstrated lower 1-year cumulative probabilities of treatment failure (49.9%) compared to sorafenib (68.4%) and temsirolimus (71.4%).
- Multivariate analysis indicated a significantly higher adjusted risk of treatment failure for temsirolimus (HR 2.05) and sorafenib (HR 1.77) versus everolimus.
Conclusions:
- Second-line treatment with everolimus after sunitinib in mRCC patients is associated with a lower risk of treatment failure compared to sorafenib and temsirolimus.
- These real-world data support everolimus as a potentially more effective second-line option in this setting.
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