Wednesday, August 21, 2013
Patients with advanced kidney cancer can now take advantage of a new treatment option that has far fewer troubling side effects – this, according to a large, international trial led by Memorial Sloan Kettering Cancer Center (MSKCC) investigators. Published in the August 22 issue of the New England Journal of Medicine, the study’s results will most likely change the current “reference standard.”
The randomized trial tested the efficacy and safety of two drugs – pazopanib (Votrient®) and sunitinib (Sutent®), the current standard of care for patients with advanced or metastatic renal cell carcinoma, a common type of kidney cancer.
“Improved quality-of-life scores were reported among the patients taking pazopanib,” said Robert Motzer, MD, a medical oncologist at MSKCC, and the study’s lead investigator. “Previous head-to-head trials testing the drug’s efficacy showed us that both had similar progression-free and survival benefits, but an increased tolerability and a more appealing safety profile are meaningful to patients and doctors, so I believe pazopanib will be the preferable choice moving forward.”
The multi-institutional study included 1,110 patients with advanced disease who had not yet received prior treatment. Excluded from the study were patients with confirmed brain metastases, uncontrolled hypertension, and cardiac or vascular conditions within six months of screening.
Results from a quality-of-life survey administered during and after the trial confirmed patients taking pazopanib reported less fatigue and fewer incidences of stomatitis (oral inflammation) and hand foot syndrome, side effects that many patients find quite worrisome, said Dr. Motzer, whose research over the years has led to the development of several targeted therapies for kidney cancer. However, patients randomized to the pazopanib arm also experienced an elevated incidence of liver toxicity. “Patients who develop this would need to be closely monitored by their doctors who might adjust the dosage or decide to change the treatment completely,” added Dr. Motzer.
Renal cell carcinoma originates in the lining of the small tubes (tubules) in the kidney. While several new treatment options have been introduced into practice over the last few years, the disease remains difficult to manage. Pazopanib and sunitinib are both multi kinase angiogenesis inhibitors that are given orally once daily. These drugs are effective because they help prevent the formation of new blood vessels that feed tumor growth.