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Pazopanib offered greater quality of life than sunitinib for patients with renal cancer
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CHICAGO — Patients with metastatic renal cell carcinoma preferred pazopanib treatment to sunitinib therapy because it offered improved quality of life and resulted in less fatigue, according to results of a randomized double-blind study.
Bernard J. Escudier, MD, a physician at the Institut Gustave Roussy in Villejuif, France, and colleagues conducted the study to evaluate whether tolerability differences were significant enough to lead a patient to prefer continuing their treatment with pazopanib (Votrient, GlaxoSmithKline) or sunitinib (Sutent, Pfizer).
Escudier and colleagues enrolled 168 patients with metastatic renal cell carcinoma in the study. Half of the patients were randomized to receive first-line treatment that consisted of pazopanib 800 mg for 10 weeks, a 2-week break and then treatment with 50 mg sunitinib for 10 weeks. The other half of patients received the sunitinib treatment first, followed by the 2-week break and then treatment with pazopanib.
Patients were stratified by ECOG performance status as well as the number of metastatic sites.
After treatment, patients were asked to complete a questionnaire to indicate their preference of treatments.
Of the 114 patients who completed the questionnaire, 70% preferred pazopanib, 22% preferred sunitinib and 8% expressed no preference.
Adjusting for a modest sequence effect, researchers observed the difference in preference was 49% (90% CI, 37%-61.5%; P<0.001) in favor of pazopanib. In addition, pre-planned sensitivity analyses conducted by researchers were statistically significant in favor of pazopanib, including one that ascribed sunitinib for all unavailable patient preference data.
Patients reported less fatigue while taking pazopanib as assessed by the FACIT-Fatigue scale (treatment difference, 2.49; P=.002). They also reported improved quality of life, fewer dose reductions (13% vs 20%) and interruptions (6% vs 12%) while taking pazopanib. The dose reductions and interruptions primarily were due to adverse events, researchers said.
Investigator-assessed response was 22% with pazopanib vs 24% with sunitinib (P=.87).
“While we expected patients would prefer one drug over the other, due to the known toxicity profiles, we didn’t expect this great a preference,” Escudier said in a press release. “This is an excellent method to report the way patients are feeling about the toxicity of drugs. It’s an important reminder that [the] low-grade toxicities patients experience may not seem bad, but if you are experiencing the toxicity over a long time, it has an effect on your quality of life. How patients feel when they take a drug over many months isn’t reflected in traditional adverse event reporting.”
For more information:
Escudier BJ. Abstract #CRA4502. Presented at: the 2012 American Society of Clinical Oncology Annual Meeting; June 1-5, 2012; Chicago.
Disclosure: The study was funded by GlaxoSmithKline. The researchers report serving as consults and advisors for, and receiving research funding and honoraria from, Avoe, Bayer, GlaxoSmithKline, Novartis, Pfizer and Roche.