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First-Line PAzopanib in NOn-clear-cell Renal cArcinoMA: The Italian Retrospective Multicenter PANORAMA Study
Sebastiano Buti1, Melissa Bersanelli1, Francesca Maines2
1University Hospital of Parma, Medical Oncology, Parma, Italy.
Introduction:
Pazopanib is a standard first-line treatment for metastatic clear-cell renal cell carcinoma (ccRCC). Very few data on its activity in non-clear-cell renal cell carcinoma (nccRCC) are currently available. The aim of this study was to retrospectively analyze efficacy and toxicity of pazopanib in nccRCC patients.
Patients And Methods:
Records from advanced nccRCC patients (consecutive sample) treated with first-line pazopanib between 2010 and 2015 at 17 Italian centers were reviewed. Response rate, progression-free survival (PFS), and overall survival (OS) were evaluated. Univariate and descriptive analyses were performed.
Results:
Thirty-seven patients with nccRCC were treated with first-line pazopanib; 51% had papillary histology, 24% chromophobe, 22% unclassified, and 3% had Xp11.2 translocation. Dose reductions/temporary interruptions for toxicity were required in 46% of cases. Grade (G) 3/4 toxicity was seen in 32%, G1/2 in 89% of cases; 81% achieved disease control, with 10 partial responses (27%) and 20 cases of stable disease (54%); 16% of patients had disease progression as best response. Median PFS and OS were 15.9 and 17.3 months, respectively. In univariate analysis, nephrectomy (P = .020), Memorial Sloan Kettering Cancer Center (MSKCC) score (P < .001), basal neutrophil/lymphocyte ratio (NLR; P = .009) and performance status (PS) (P = .001) were associated with PFS; MSKCC score (P < .001), International Metastatic Renal Cell Carcinoma Database Consortium score (P = .003), PS (P < .0001), nephrectomy (P = .002), histology (P = .035), dose reductions/interruptions (P = .039), best response to treatment (P < .001), and NLR (P = .008) were associated with OS.
Conclusion:
In nccRCC patients, treatment with pazopanib was effective and feasible; dose reductions required for toxicity were similar as expected in ccRCC.
Insights
Pazopanib shows efficacy and feasibility in non-clear-cell renal cell carcinoma (nccRCC) patients, with manageable toxicity. This study provides valuable data on its use in this patient population.
Area of Science:
- Oncology
- Pharmacology
- Clinical Medicine
Background:
- Pazopanib is a standard first-line treatment for metastatic clear-cell renal cell carcinoma (ccRCC).
- Limited data exist on pazopanib's efficacy in non-clear-cell renal cell carcinoma (nccRCC).
Purpose of the Study:
- To retrospectively analyze the efficacy and toxicity of pazopanib in patients with nccRCC.
- To evaluate response rate, progression-free survival (PFS), and overall survival (OS) in nccRCC patients treated with pazopanib.
Main Methods:
- Retrospective review of advanced nccRCC patients treated with first-line pazopanib (2010-2015) across 17 Italian centers.
- Evaluation of response rate, PFS, OS, and toxicity.
- Univariate and descriptive analyses were performed.
Main Results:
- Thirty-seven nccRCC patients received first-line pazopanib; common histologies included papillary (51%), chromophobe (24%), and unclassified (22%).
- 81% achieved disease control (27% partial response, 54% stable disease); median PFS was 15.9 months and median OS was 17.3 months.
- Toxicity required dose reductions/interruptions in 46% of patients; Grade 3/4 toxicity occurred in 32%.
Conclusions:
- Pazopanib demonstrated effectiveness and feasibility in nccRCC patients.
- Toxicity and required dose modifications were comparable to those observed in ccRCC.
- The study provides crucial insights into pazopanib's role in nccRCC management.
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