Related Experiment Video

Updated: May 7, 2026

Drug-Induced Senescence in Liver Cells Promotes M2 Macrophage Polarization: Implications for Tyrosine Kinase Inhibitor-Associated Hepatotoxicity
09:32

Drug-Induced Senescence in Liver Cells Promotes M2 Macrophage Polarization: Implications for Tyrosine Kinase Inhibitor-Associated Hepatotoxicity

Published on: October 17, 2025

Sorafenib and sunitinib for elderly patients with renal cell carcinoma

Olfa Derbel Miled1, Christine Dionne, Catherine Terret

  • 1Department of Medical Oncology, Centre Léon-Bérard, Lyon, France.

Journal of Geriatric Oncology
|September 28, 2013
PubMed
Abstract

Insights

First-line sunitinib and sorafenib show similar effectiveness in elderly patients with advanced renal cell carcinoma. However, sunitinib is less tolerated, and sequential therapy may improve tolerance.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Sunitinib and sorafenib are small-molecule tyrosine kinase inhibitors with established antitumor activity.
  • Advanced renal cell carcinoma (RCC) is a significant clinical challenge.

Purpose of the Study:

  • To assess the response and tolerance of elderly patients (≥70 years) with advanced renal cell carcinoma to sunitinib and sorafenib.
  • To compare first-line treatment efficacy and sequential treatment outcomes.

Main Methods:

  • Retrospective analysis of 60 elderly patients with advanced RCC treated with sorafenib or sunitinib.
  • Evaluation of objective responses (OR), stable disease (SD), toxicity, overall survival (OS), and progression-free survival (PFS).

Main Results:

  • Similar OR+SD rates for first-line sorafenib (79%) and sunitinib (71%).
  • Median PFS: 6 months (sorafenib) vs. 5 months (sunitinib). Median OS: 16 months (sorafenib) vs. 15 months (sunitinib).
  • Sequential sorafenib then sunitinib showed median PFS of 11.5 months and OS of 13.1 months; reverse sequence had median PFS of 8.1 months and OS of 15 months. Sunitinib required more treatment modifications.

Conclusions:

  • First-line sunitinib and sorafenib demonstrate comparable efficacy in elderly advanced RCC patients.
  • Sunitinib is associated with lower tolerance compared to sorafenib.
  • Sequential treatment with sorafenib followed by sunitinib appears better tolerated and warrants further investigation in prospective studies.

More Related Videos

An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis06:38

An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis

Published on: September 12, 2019

Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma09:11

Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma

Published on: May 24, 2024

Related Concept Videos

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...