Evaluation of the effectiveness and tolerability of sunitinib and pazopanib in the first line treatment of metastatic renal cell carcinoma

Introduction. It is known that sunitinib and pazopanib are effective in the first-line and subsequent treatment of metastatic renal cell carcinoma (mRCC). This study aims to investigate the effectiveness and tolerability of sunitinib and pazopanib in the first-line treatment of mRCC. Material and methods. This study included 78 patients followed up in our clinic due to a diagnosis of mRCC, who received pazopanib or sunitinib treatment between 2006 and 2020. Along with clinical and laboratory findings, survival times obtained with each treatment and medication side effects were assessed. Sunitinib and pazopanib were compared in terms of effectiveness (ORR, PFS and OS) and tolerability. Results. The patients’ median age at diagnosis was 55 years (25–81). In the first-line treatment, 54 patients (69.2%) received sunitinib and 24 (30.8%) received pazopanib. The comparison of sunitinib and pazopanib yielded an ORR of 66.7% vs. 45.8% (p = 0.08), PFS of 24 months vs. 19 months (p = 0.66) and OS of 27 months vs. 30 months (p = 0.73), respectively. The most common side effect was hypothyroidism in those on sunitinib (25.9%) and nausea-vomiting in those on pazopanib (41.7%). In our study, hemoglobin ≥ 13 g/dL, an ECOG PS of 0–1 and the occurrence of hypothyroidism as a medication side effect were found to be predictive factors of PFS for both agents. An International Metastatic RCC Database Consortium score corresponding to the poor risk group was associated with a poor PFS. Conclusions. This study, which provides current real-world data, confirms that sunitinib and pazopanib have similar effectiveness and side-effect profiles in the first-line treatment of mRCC.