Sunitinib, Pazopanib or Sorafenib for the Treatment of Patients with Late Relapsing Metastatic Renal Cell Carcinoma

Matteo Santoni, Alessandro Conti, Camillo Porta, Giuseppe Procopio, Cora N. Sternberg, Umberto Basso, Ugo De Giorgi, Sergio Bracarda, Mimma Rizzo, Cinzia Ortega, Francesco Massari, Roberto Iacovelli, Lisa Derosa, Cristina Masini, Michele Milella, Giuseppe Di Lorenzo, Francesco Atzori, Maria Pagano, Sebastiano Buti, Rocco De VivoAlessandra Mosca, Marta Rossi, Chiara Paglino, Elena Verzoni, Linda Cerbone, Giovanni Muzzonigro, Massimo Falconi, Rodolfo Montironi, Luciano Burattini, Daniele Santini, Stefano Cascinu

Research output: Contribution to journalArticle


Purpose: Late recurrence of renal cell carcinoma is not a rare event. In this retrospective study we investigate the clinicopathological features and the outcome of patients treated with sorafenib, sunitinib and pazopanib for late relapsing renal cell carcinoma. Materials and Methods: Data were collected from 21 Italian centers involved in the treatment of metastatic renal cell carcinoma. Late relapse was defined as more than 5 years after initial radical nephrectomy. Results: A total of 2,490 patients were screened and 269 (11%) were included in the study. First line therapy was sunitinib in 190 patients (71%), sorafenib in 58 (21%) and pazopanib in 21 (8%). Median progression-free survival was 20.0 months for sunitinib (95% CI 17.0-25.1), and 14.1 months for sorafenib (95% CI 11.0-29.0) and pazopanib (95% CI 11.2-not reported). On multivariate analysis MSKCC score and metastases to lymph nodes, liver and brain were associated with worst overall survival, while pancreatic metastases were associated with longer survival. Furthermore, age, MSKCC score and brain metastases were associated with worst progression-free survival. Conclusions: Patients with late relapsing renal cell carcinoma seem to present a characteristic pattern of metastatic spread without showing significant differences in terms of progression-free survival among sorafenib, sunitinib and pazopanib.

Original languageEnglish
JournalJournal of Urology
Publication statusAccepted/In press - 2015


  • Carcinoma
  • Protein-tyrosine kinases
  • Recurrence
  • Renal cell
  • Survival

ASJC Scopus subject areas

  • Urology

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