ESMO 2017: Evaluating Multikinase Inhibitor Sequence in Advanced Renal Cell Carcinoma
Several years ago, the SWITCH study evaluated the sequence of sunitinib and sorafenib for the treatment of advanced/metastatic renal cell carcinoma, showing similar progression-free and overall survival regardless of the order in which the drugs were administered. At the 2017 European Society for Medical Oncology (ESMO) Congress, Margitta Retz, MD, of the Technical University of Munich, presented the results of the phase III SWITCH-II trial (Abstract 845O), which focused on the sequencing of sorafenib and pazopanib in this patient population.
A total of 377 patients with advanced renal cell carcinoma of any histology took part in the SWITCH-II trial. None of them had undergone prior systemic therapy. The patients were randomized to receive sorafenib followed by pazopanib (n=189) or pazopanib followed by sorafenib (n=188).
Median progression-free survival was 8.6 months for those who were treated with sorafenib followed by pazopanib and 12.9 months for those who were treated with pazopanib followed by sorafenib. Therefore, the noninferiority endpoint was not met.
However, marked statistical differences were noted in favor of the pazopanib followed by sorafenib sequence in terms of total time to disease progression, first-line progression-free survival, and disease control rate—but not for overall survival and second-line progression-free survival, the investigators revealed.