First-line pazopanib in patients with advanced non-clear cell renal carcinoma: An Italian case series

World J Clin Oncol. 2021 Nov 24;12(11):1037-1046. doi: 10.5306/wjco.v12.i11.1037.

Abstract

Background: Non-clear cell (ncc) metastatic renal-cell carcinoma (RCC) has dismal results with standard systemic therapies and a generally worse prognosis when compared to its clear-cell counterpart. New systemic combination therapies have emerged for metastatic RCC (mRCC), but the pivotal phase III trials excluded patients with nccRCC, which constitute about 30% of metastatic RCC cases.

Aim: To provide a piece of real-life evidence on the use of pazopanib in this patient subgroup.

Methods: The present study is a multicenter retrospective observational analysis aiming to assess the activity, efficacy, and safety of pazopanib as first-line therapy for advanced nccRCC patients treated in a real-life setting.

Results: Overall, 48 patients were included. At the median follow-up of 40.6 mo, the objective response rate was 27.1%, the disease control rate was 83.3%, and the median progression-free survival and overall survival were 12.3 (95% confidence interval [CI]: 3.6-20.9) and 27.7 (95%CI: 18.2-37.1) mo, respectively. Grade 3 adverse events occurred in 20% of patients, and no grade 4 or 5 toxicities were found.

Conclusion: Pazopanib should be considered as a good first-line option for metastatic RCC with variant histology.

Keywords: Kidney cancer; Non-clear cell; Pazopanib; Renal-cell carcinoma; Tyrosine kinase inhibitors; Variant histology.