MIAMI – Clinical outcomes with everolimus as a second targeted therapy were not significantly different between patients with advanced renal cell carcinoma (aRCC) who received first-line pazopanib or sunitinib/sorafenib, a study presented at the 14th International Kidney Cancer Symposium 2015 (IKCS) has shown.1

Because sequential use of targeted therapy became the mainstay of treatment for patients with aRCC, researchers sought to evaluate the differences in real-world outcomes between use of different first-line targeted therapies followed by everolimus as second targeted therapy.

“Due to the relatively recent approval of pazopanib, there are no real-world studies comparing clinical outcomes of patients treated with everolimus as second target therapy following the failure of first targeted therapy with pazopanib versus those following the failure of first targeted therapy with sunitinib or sorafenib,” Sumanta K. Pal, MD, of City of Hope in Duarte, CA, said during the poster presentation.

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Researchers analyzed data from 696 eligible patients who received pazopanib, sunitinib, or sorafenib as first targeted therapy and everolimus as second targeted therapy from 3 retrospective U.S. chart review studies conducted between 2011 and 2014. Patients were classified as having received pazopanib or as having received sunitinib/sorafenib as first targeted therapy.

Results showed no significant differences in overall survival, time to treatment failure, or time to treatment discontinuation following everolimus initiation between the 2 treatment groups.

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Pooled hazard ratios for the 3 studies for overall survival, time to treatment failure, and time to treatment discontinuation were 0.79 (95% CI, 0.49 – 1.26), 0.87 (95% CI, 0.53 – 1.44), and 0.89 (95% CI, 0.50 – 1.58), respectively, which were adjusted for age, gender, duration of first targeted therapy, RCC subtype, metastatic sites, and Eastern Cooperative Oncology Group performance status at the time of everolimus initiation.

“There is no evidence that outcomes with everolimus following first targeted therapy with pazopanib differ from those with everolimus following currently on-label TKIs sunitinib or sorafenib,” Dr. Pal concluded.


  1. Pal SK, Signorovitch JE, Nanxin L, et al. Real-world effectiveness of everolimus subsequent to different first targeted therapies (TTs) for the treatment of advanced renal cell carcinoma (aRCC): synthesis of three retrospective chart reviews [abstract]. BJU Int. 2015. doi: 10.1111/bju.13365.