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Everolimus or sunitinib as first-line treatment of metastatic papillary renal cell carcinoma: A retrospective study of the GETUG group (Groupe d’Etude des Tumeurs Uro-Génitales)

Two phase II trials (NCT00688753 and NCT00541008) reported efficacy data of sunitinib and everolimus in first-line treatment of metastatic papillary renal cell carcinoma (mpRCC). Although most patients receive sunitinib or a mammalian target of rapamycin (mTOR) inhibitor in first- and second-line tr...

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Published in:European journal of cancer (1990) 2021-11, Vol.158, p.1-11
Main Authors: Cancel, Mathilde, Fromont, Gaelle, Blonz, Cyriac, Chevreau, Christine, Rioux-Leclercq, Nathalie, Laguerre, Brigitte, Oudard, Stéphane, Gross-Goupil, Marine, Gravis, Gwenaelle, Goldwasser, François, Rolland, Frédéric, Delva, Rémy, Moise, Laura, Emambux, Sheik, Vassal, Cécile, Zanetta, Sylvie, Penel, Nicolas, Fléchon, Aude, Barthélémy, Philippe, Saldana, Carolina, Lefort, Félix, Escudier, Bernard, Linassier, Claude, Albiges, Laurence
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Language:English
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Summary:Two phase II trials (NCT00688753 and NCT00541008) reported efficacy data of sunitinib and everolimus in first-line treatment of metastatic papillary renal cell carcinoma (mpRCC). Although most patients receive sunitinib or a mammalian target of rapamycin (mTOR) inhibitor in first- and second-line treatment, the optimal strategy remained unknown. In 23 centres of the Groupe d’Etude des Tumeurs Urogénitales group, after centralised pathological review, we analysed retrospectively progression-free survival (PFS) of patients with mpRCC treated in first-line treatment (PFS-1) with sunitinib or everolimus (primary end-point), PFS in second-line treatment (PFS-2), overall survival (OS), objective response rate, disease control rate (DCR), overall sequence and prognostic factors for OS (secondary end-points). One hundred thirty-eight patients (119 men and 19 women), median age 62.5 years, with mpRCC type 1 (n = 24) or non–type 1 (n = 114), received first-line sunitinib (n = 107) or everolimus (n = 31). With a median follow-up of 92 months, we found no significant difference between the treatment groups in terms of PFS-1 (5.5 versus 6.2 months) and DCR (69% versus 83%). Ninety-eight patients received a second-line treatment, 69% with mTOR inhibitors after sunitinib and 100% with tyrosine kinase inhibitors after everolimus, with similar DCR (64% versus 58%), median PFS-2 (3.4 versus 4.8 months) and OS (16.0 versus 20.3 months). No factor was prognostic for PFS-1, whereas leukocytosis, anaemia and the time from diagnosis to first systemic therapy 
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2021.08.046