Sequence of Everolimus and Sunitinib in Metastatic Renal Cell Carcinoma
The sequence of sunitinib followed by everolimus at disease progression in patients with metastatic renal cell carcinoma is supported by the final overall survival results of the phase II RECORD-3 study, conducted by Jennifer J. Knox, MSc, MD, FRCPC, of Princess Margaret Cancer Centre, University of Toronto, and colleagues. In addition, no unexpected safety signals were reported with either drug, in the publication of these findings in the Annals of Oncology.
A total of 471 patients took part in this clinical trial, with 238 receiving first-line treatment with everolimus followed by second-line sunitinib (everolimus-sunitinib) at disease progression and 233 receiving first-line treatment with sunitinib followed by second-line everolimus (sunitinib-everolimus). The median combined progression-free survival was longer with sunitinib-everolimus than with everolimus-sunitinib (22.2 vs. 21.7 months). The median overall survival was also better with the use of sunitinib first and then everolimus than everolimus first and then sunitinib: 29.5 vs. 22.4 months.
In this final analysis, the adverse events remained consistent with the known safety profiles of both agents. With second-line everolimus, the most commonly reported side effects were fatigue, stomatitis, and anemia; with second-line sunitinib, the most commonly reported side effects were diarrhea, fatigue, and nausea.