The outcome to axitinib or everolimus after sunitinib in metastatic renal cell carcinoma

R. Iacovelli, M. Cossu Rocca, L. Galli, R. Sabbatini, U. De Giorgi, D. Santini, G. Facchini, A. Mosca, F. Atzori, P. Zucali, G. Fornarini, F. Massari, S. Buti, R. Ricotta, C. Masini, I. Toscani, E. Biasco, A. Guida, C. Lolli, D. De LisiS. Rossetti, C. Terrone, M. Scartozzi, C. Miggiano, A. Pastorino, M. Bersanelli, G. Carlo-Stella, C. Pinto, E. Nobili, F. Nolè, G. Tortora, C. Porta

Research output: Contribution to journalArticle

Abstract

We aimed to investigate the different outcomes in patients with metastatic renal cell carcinoma treated with second-line axitinib or everolimus after sunitinib. Patients treated in 16 oncological centres in Italy were included, and those receiving axitinib or everolimus from January 2013 onwards were analysed for outcomes. Descriptive statistical tests were used to highlight differences between groups. The Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS). Data on 634 patients with metastatic renal cell carcinoma treated with first-line sunitinib have been obtained. A total of 182 patients received a second-line therapy with everolimus (79 patients, 43%) or axitinib (103 patients, 57%), respectively. The median PFS was 4.6 [95% confidence (CI): 2.6-6.5] months for patients treated with everolimus and 5.5 (95% CI: 4.3-6.7) months for patients treated with axitinib (P=0.7). The median OS was 13.9 (95% CI: 10.4-17.4) months for patients treated with everolimus and 12.0 (95% CI: 7.9-16.2) months for patients treated with axitinib (P=0.3). No differences were found based on length of first-line treatment. Major limitations are the retrospective nature of the study and the lack of a prospective evaluation of the progression. This study reports no significantly differences between everolimus and axitinib in terms of both PFS and OS. Furthermore, the length of first-line treatment cannot be used as such a predictive factor and cannot suggest the use of a molecule compared with another. © 2018 Wolters Kluwer Health, Inc. All rights reserved.
Original languageEnglish
Pages (from-to)705-709
Number of pages5
JournalAnti-Cancer Drugs
Volume29
Issue number7
DOIs
Publication statusPublished - 2018

Fingerprint

Renal Cell Carcinoma
Disease-Free Survival
Survival
sunitinib
axitinib
Everolimus
Italy
Therapeutics
Retrospective Studies
Health

Keywords

  • axitinib
  • everolimus
  • mammalian target of rapamycin
  • metastatic renal cell carcinoma
  • second-line
  • sequence
  • sunitinib
  • tyrosine kinase inhibitor
  • adult
  • Article
  • cancer chemotherapy
  • cancer surgery
  • cancer survival
  • clinical outcome
  • disease exacerbation
  • female
  • follow up
  • human
  • kidney metastasis
  • major clinical study
  • male
  • middle aged
  • nephrectomy
  • overall survival
  • priority journal
  • progression free survival
  • renal cell carcinoma
  • treatment outcome

Cite this

The outcome to axitinib or everolimus after sunitinib in metastatic renal cell carcinoma. / Iacovelli, R.; Cossu Rocca, M.; Galli, L.; Sabbatini, R.; De Giorgi, U.; Santini, D.; Facchini, G.; Mosca, A.; Atzori, F.; Zucali, P.; Fornarini, G.; Massari, F.; Buti, S.; Ricotta, R.; Masini, C.; Toscani, I.; Biasco, E.; Guida, A.; Lolli, C.; De Lisi, D.; Rossetti, S.; Terrone, C.; Scartozzi, M.; Miggiano, C.; Pastorino, A.; Bersanelli, M.; Carlo-Stella, G.; Pinto, C.; Nobili, E.; Nolè, F.; Tortora, G.; Porta, C.

In: Anti-Cancer Drugs, Vol. 29, No. 7, 2018, p. 705-709.

Research output: Contribution to journalArticle

Iacovelli, R, Cossu Rocca, M, Galli, L, Sabbatini, R, De Giorgi, U, Santini, D, Facchini, G, Mosca, A, Atzori, F, Zucali, P, Fornarini, G, Massari, F, Buti, S, Ricotta, R, Masini, C, Toscani, I, Biasco, E, Guida, A, Lolli, C, De Lisi, D, Rossetti, S, Terrone, C, Scartozzi, M, Miggiano, C, Pastorino, A, Bersanelli, M, Carlo-Stella, G, Pinto, C, Nobili, E, Nolè, F, Tortora, G & Porta, C 2018, 'The outcome to axitinib or everolimus after sunitinib in metastatic renal cell carcinoma', Anti-Cancer Drugs, vol. 29, no. 7, pp. 705-709. https://doi.org/10.1097/CAD.0000000000000632
Iacovelli, R. ; Cossu Rocca, M. ; Galli, L. ; Sabbatini, R. ; De Giorgi, U. ; Santini, D. ; Facchini, G. ; Mosca, A. ; Atzori, F. ; Zucali, P. ; Fornarini, G. ; Massari, F. ; Buti, S. ; Ricotta, R. ; Masini, C. ; Toscani, I. ; Biasco, E. ; Guida, A. ; Lolli, C. ; De Lisi, D. ; Rossetti, S. ; Terrone, C. ; Scartozzi, M. ; Miggiano, C. ; Pastorino, A. ; Bersanelli, M. ; Carlo-Stella, G. ; Pinto, C. ; Nobili, E. ; Nolè, F. ; Tortora, G. ; Porta, C. / The outcome to axitinib or everolimus after sunitinib in metastatic renal cell carcinoma. In: Anti-Cancer Drugs. 2018 ; Vol. 29, No. 7. pp. 705-709.
@article{1df318b9056943a68971319e4db9f6c5,
title = "The outcome to axitinib or everolimus after sunitinib in metastatic renal cell carcinoma",
abstract = "We aimed to investigate the different outcomes in patients with metastatic renal cell carcinoma treated with second-line axitinib or everolimus after sunitinib. Patients treated in 16 oncological centres in Italy were included, and those receiving axitinib or everolimus from January 2013 onwards were analysed for outcomes. Descriptive statistical tests were used to highlight differences between groups. The Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS). Data on 634 patients with metastatic renal cell carcinoma treated with first-line sunitinib have been obtained. A total of 182 patients received a second-line therapy with everolimus (79 patients, 43{\%}) or axitinib (103 patients, 57{\%}), respectively. The median PFS was 4.6 [95{\%} confidence (CI): 2.6-6.5] months for patients treated with everolimus and 5.5 (95{\%} CI: 4.3-6.7) months for patients treated with axitinib (P=0.7). The median OS was 13.9 (95{\%} CI: 10.4-17.4) months for patients treated with everolimus and 12.0 (95{\%} CI: 7.9-16.2) months for patients treated with axitinib (P=0.3). No differences were found based on length of first-line treatment. Major limitations are the retrospective nature of the study and the lack of a prospective evaluation of the progression. This study reports no significantly differences between everolimus and axitinib in terms of both PFS and OS. Furthermore, the length of first-line treatment cannot be used as such a predictive factor and cannot suggest the use of a molecule compared with another. {\circledC} 2018 Wolters Kluwer Health, Inc. All rights reserved.",
keywords = "axitinib, everolimus, mammalian target of rapamycin, metastatic renal cell carcinoma, second-line, sequence, sunitinib, tyrosine kinase inhibitor, adult, Article, cancer chemotherapy, cancer surgery, cancer survival, clinical outcome, disease exacerbation, female, follow up, human, kidney metastasis, major clinical study, male, middle aged, nephrectomy, overall survival, priority journal, progression free survival, renal cell carcinoma, treatment outcome",
author = "R. Iacovelli and {Cossu Rocca}, M. and L. Galli and R. Sabbatini and {De Giorgi}, U. and D. Santini and G. Facchini and A. Mosca and F. Atzori and P. Zucali and G. Fornarini and F. Massari and S. Buti and R. Ricotta and C. Masini and I. Toscani and E. Biasco and A. Guida and C. Lolli and {De Lisi}, D. and S. Rossetti and C. Terrone and M. Scartozzi and C. Miggiano and A. Pastorino and M. Bersanelli and G. Carlo-Stella and C. Pinto and E. Nobili and F. Nol{\`e} and G. Tortora and C. Porta",
note = "Cited By :1 Export Date: 5 February 2019 CODEN: ANTDE Correspondence Address: Iacovelli, R.; Medical Oncology Unit, Integrated University Hospital of Verona (AOUI), Piazzale L.A. Scuro 10, Italy; email: roberto.iacovelli@aovr.veneto.it Chemicals/CAS: axitinib, 319460-85-0; everolimus, 159351-69-6; sunitinib, 341031-54-7, 557795-19-4 Funding details: Fondazione IRCCS Policlinico San Matteo Funding details: Universit{\`a} Campus Bio-Medico di Roma Funding details: National Cancer Institute, NCI Funding details: European Society for Medical Oncology, ESMO Funding text 1: aMedical Oncology Unit, Integrated University Hospital of Verona (AOUI), Verona, bMedical Oncology Division of Urogenital and Head & Neck Tumours, European Institute of Oncology, cHumanitas Clinical and Research Center, Humanitas Cancer Center, Rozzano, dNiguarda Cancer Center, Great Niguarda Metropolitan Hospital, Milan, eDepartment of Medical Oncology 2, AOUP, Tuscan Cancer Institute (ITT), Pisa, fDepartment of Oncology and Haematology and Respiratory Disease, University Hospital, Modena, gDepartment of Medical Oncology, Scientific Institute Romagnolo for the Study and Treatment of Tumors (IRST) IRCCS, Meldola, hDepartment of Medical Oncology, Campus Bio-Medico University of Rome, Rome, iDepartment of Uro-Gynaecological Oncology, Division of Medical Oncology, National Cancer Institute – IRCCS – G. Pascale Foundation, Napoli, jDepartment of Medical Oncology & Urology, Maggiore della Carit{\`a} University Hospital, University of Eastern Piedmont, Novara, kMedical Oncology Unit, Civil Hospital – University Hospital of Cagliari, Cagliari, lDepartment of Medical Oncology, IRCCS University Hospital San Martino – IST National Institute for Cancer Research, Genova, mDivision of Oncology, S.Orsola-Malpighi Hospital, Bologna, nMedical Oncology Unit, University Hospital of Parma, Parma, oMedical Oncology Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia and pDepartment of Medical Oncology, IRCCS, San Matteo University Hospital Foundation, Pavia, Italy References: Rini, B.I., Escudier, B., Tomczak, P., Kaprin, A., Szczylik, C., Hutson, T.E., Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): A randomised phase 3 trial (2011) Lancet, 378, pp. 1931-1939; Motzer, R.J., Escudier, B., Oudard, S., Hutson, T.E., Porta, C., Bracarda, S., Efficacy of everolimus in advanced renal cell carcinoma: A double-blind, randomised, placebo-controlled phase III trial (2008) Lancet, 372, pp. 449-456; Choueiri, T.K., Motzer, R.J., Systemic therapy for metastatic renal-cell carcinoma (2017) N Engl J Med, 376, pp. 354-366; Sherman, S., Amzal, B., Calvo, E., Wang, X., Park, J., Liu, Z., An indirect comparison of everolimus versus axitinib in us patients with advanced renal cell carcinoma in whom prior sunitinib therapy failed (2015) Clin Ther, , [Epub ahead of print]; Heng, D.Y., Xie, W., Regan, M.M., Warren, M.A., Golshayan, A.R., Sahi, C., Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: Results from a large, multicenter study (2009) J Clin Oncol, 27, pp. 5794-5799; Porta, C., Giglione, P., Paglino, C., Targeted therapy for renal cell carcinoma: Focus on 2nd and 3rd line (2016) Expert Opin Pharmacother, 17, pp. 643-655; Motzer, R.J., Escudier, B., Oudard, S., Hutson, T.E., Porta, C., Bracarda, S., Phase 3 trial of everolimus for metastatic renal cell carcinoma: Final results and analysis of prognostic factors (2010) Cancer, 116, pp. 4256-4265; Motzer, R.J., Barrios, C.H., Kim, T.M., Falcon, S., Cosgriff, T., Harker, W.G., Phase II randomized trial comparing sequential first-line everolimus and second-line sunitinib versus first-line sunitinib and second-line everolimus in patients with metastatic renal cell carcinoma (2014) J Clin Oncol, 32, pp. 2765-2772; Knox, J.J., Barrios, C.H., Kim, T.M., Cosgriff, T., Srimuninnimit, V., Pittman, K., Final overall survival analysis for the phase II RECORD-3 Study of first-line everolimus followed by sunitinib versus first-line sunitinib followed by everolimus in metastatic RCC (2017) Ann Oncol, 28, pp. 1339-1345; Motzer, R.J., Escudier, B., Tomczak, P., Hutson, T.E., Michaelson, M.D., Negrier, S., Axitinib versus sorafenib as second-line treatment for advanced renal cell carcinoma: Overall survival analysis and updated results from a randomised phase 3 trial (2013) Lancet Oncol, 14, pp. 552-562; Guida, A., Albiges, L., Derosa, L., Loriot, Y., Massard, C., Fizazi, K., Everolimus versus axitinib as second-line therapy in metastatic renal cell carcinoma: Experience from Institut Gustave Roussy (2017) Clin Genitourin Cancer, 15, pp. e1081-e1088; Hutson, T.E., Escudier, B., Esteban, E., Bjarnason, G.A., Lim, H.Y., Pittman, K.B., Randomized phase III trial of temsirolimus versus sorafenib as second-line therapy after sunitinib in patients with metastatic renal cell carcinoma (2014) J Clin Oncol, 32, pp. 760-767; Iacovelli, R., Santoni, M., Verzoni, E., Grassi, P., Testa, I., De Braud, F., Everolimus and temsirolimus are not the same second-line in metastatic renal cell carcinoma. A systematic review and meta-analysis of literature data (2015) Clin Genitourin Cancer, 13, pp. 137-141; Motzer, R.J., Escudier, B., McDermott, D.F., George, S., Hammers, H.J., Srinivas, S., Nivolumab versus everolimus in advanced renal-cell carcinoma (2015) N Engl J Med, 373, pp. 1803-1813; Choueiri, T.K., Escudier, B., Powles, T., Mainwaring, P.N., Rini, B.I., Donskov, F., Cabozantinib versus everolimus in advanced renal-cell carcinoma (2015) N Engl J Med, 373, pp. 1814-1823; Powles, T., Staehler, M., Ljungberg, B., Bensalah, K., Canfield, S.E., Dabestani, S., European Association of Urology guidelines for clear cell renal cancers that are resistant to vascular endothelial growth factor receptor-targeted therapy (2016) Eur Urol, 70, pp. 705-706; Escudier, B., Porta, C., Schmidinger, M., Rioux-Leclercq, N., Bex, A., Khoo, V., Renal cell carcinoma: ESMO Clinical Practice guidelines for diagnosis, treatment and follow-up (2016) Ann Oncol, 27, pp. v58-v68; Derosa, L., Guida, A., Albiges, L., Massard, C., Loriot, Y., Biasco, E., New prognostic factors for second-line targeted therapy (TT) metastatic renal cell carcinoma (mRCC) (2015) Ann Oncol, 26, p. vi53",
year = "2018",
doi = "10.1097/CAD.0000000000000632",
language = "English",
volume = "29",
pages = "705--709",
journal = "Anti-Cancer Drugs",
issn = "0959-4973",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - The outcome to axitinib or everolimus after sunitinib in metastatic renal cell carcinoma

AU - Iacovelli, R.

AU - Cossu Rocca, M.

AU - Galli, L.

AU - Sabbatini, R.

AU - De Giorgi, U.

AU - Santini, D.

AU - Facchini, G.

AU - Mosca, A.

AU - Atzori, F.

AU - Zucali, P.

AU - Fornarini, G.

AU - Massari, F.

AU - Buti, S.

AU - Ricotta, R.

AU - Masini, C.

AU - Toscani, I.

AU - Biasco, E.

AU - Guida, A.

AU - Lolli, C.

AU - De Lisi, D.

AU - Rossetti, S.

AU - Terrone, C.

AU - Scartozzi, M.

AU - Miggiano, C.

AU - Pastorino, A.

AU - Bersanelli, M.

AU - Carlo-Stella, G.

AU - Pinto, C.

AU - Nobili, E.

AU - Nolè, F.

AU - Tortora, G.

AU - Porta, C.

N1 - Cited By :1 Export Date: 5 February 2019 CODEN: ANTDE Correspondence Address: Iacovelli, R.; Medical Oncology Unit, Integrated University Hospital of Verona (AOUI), Piazzale L.A. Scuro 10, Italy; email: roberto.iacovelli@aovr.veneto.it Chemicals/CAS: axitinib, 319460-85-0; everolimus, 159351-69-6; sunitinib, 341031-54-7, 557795-19-4 Funding details: Fondazione IRCCS Policlinico San Matteo Funding details: Università Campus Bio-Medico di Roma Funding details: National Cancer Institute, NCI Funding details: European Society for Medical Oncology, ESMO Funding text 1: aMedical Oncology Unit, Integrated University Hospital of Verona (AOUI), Verona, bMedical Oncology Division of Urogenital and Head & Neck Tumours, European Institute of Oncology, cHumanitas Clinical and Research Center, Humanitas Cancer Center, Rozzano, dNiguarda Cancer Center, Great Niguarda Metropolitan Hospital, Milan, eDepartment of Medical Oncology 2, AOUP, Tuscan Cancer Institute (ITT), Pisa, fDepartment of Oncology and Haematology and Respiratory Disease, University Hospital, Modena, gDepartment of Medical Oncology, Scientific Institute Romagnolo for the Study and Treatment of Tumors (IRST) IRCCS, Meldola, hDepartment of Medical Oncology, Campus Bio-Medico University of Rome, Rome, iDepartment of Uro-Gynaecological Oncology, Division of Medical Oncology, National Cancer Institute – IRCCS – G. Pascale Foundation, Napoli, jDepartment of Medical Oncology & Urology, Maggiore della Carità University Hospital, University of Eastern Piedmont, Novara, kMedical Oncology Unit, Civil Hospital – University Hospital of Cagliari, Cagliari, lDepartment of Medical Oncology, IRCCS University Hospital San Martino – IST National Institute for Cancer Research, Genova, mDivision of Oncology, S.Orsola-Malpighi Hospital, Bologna, nMedical Oncology Unit, University Hospital of Parma, Parma, oMedical Oncology Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia and pDepartment of Medical Oncology, IRCCS, San Matteo University Hospital Foundation, Pavia, Italy References: Rini, B.I., Escudier, B., Tomczak, P., Kaprin, A., Szczylik, C., Hutson, T.E., Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): A randomised phase 3 trial (2011) Lancet, 378, pp. 1931-1939; Motzer, R.J., Escudier, B., Oudard, S., Hutson, T.E., Porta, C., Bracarda, S., Efficacy of everolimus in advanced renal cell carcinoma: A double-blind, randomised, placebo-controlled phase III trial (2008) Lancet, 372, pp. 449-456; Choueiri, T.K., Motzer, R.J., Systemic therapy for metastatic renal-cell carcinoma (2017) N Engl J Med, 376, pp. 354-366; Sherman, S., Amzal, B., Calvo, E., Wang, X., Park, J., Liu, Z., An indirect comparison of everolimus versus axitinib in us patients with advanced renal cell carcinoma in whom prior sunitinib therapy failed (2015) Clin Ther, , [Epub ahead of print]; Heng, D.Y., Xie, W., Regan, M.M., Warren, M.A., Golshayan, A.R., Sahi, C., Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: Results from a large, multicenter study (2009) J Clin Oncol, 27, pp. 5794-5799; Porta, C., Giglione, P., Paglino, C., Targeted therapy for renal cell carcinoma: Focus on 2nd and 3rd line (2016) Expert Opin Pharmacother, 17, pp. 643-655; Motzer, R.J., Escudier, B., Oudard, S., Hutson, T.E., Porta, C., Bracarda, S., Phase 3 trial of everolimus for metastatic renal cell carcinoma: Final results and analysis of prognostic factors (2010) Cancer, 116, pp. 4256-4265; Motzer, R.J., Barrios, C.H., Kim, T.M., Falcon, S., Cosgriff, T., Harker, W.G., Phase II randomized trial comparing sequential first-line everolimus and second-line sunitinib versus first-line sunitinib and second-line everolimus in patients with metastatic renal cell carcinoma (2014) J Clin Oncol, 32, pp. 2765-2772; Knox, J.J., Barrios, C.H., Kim, T.M., Cosgriff, T., Srimuninnimit, V., Pittman, K., Final overall survival analysis for the phase II RECORD-3 Study of first-line everolimus followed by sunitinib versus first-line sunitinib followed by everolimus in metastatic RCC (2017) Ann Oncol, 28, pp. 1339-1345; Motzer, R.J., Escudier, B., Tomczak, P., Hutson, T.E., Michaelson, M.D., Negrier, S., Axitinib versus sorafenib as second-line treatment for advanced renal cell carcinoma: Overall survival analysis and updated results from a randomised phase 3 trial (2013) Lancet Oncol, 14, pp. 552-562; Guida, A., Albiges, L., Derosa, L., Loriot, Y., Massard, C., Fizazi, K., Everolimus versus axitinib as second-line therapy in metastatic renal cell carcinoma: Experience from Institut Gustave Roussy (2017) Clin Genitourin Cancer, 15, pp. e1081-e1088; Hutson, T.E., Escudier, B., Esteban, E., Bjarnason, G.A., Lim, H.Y., Pittman, K.B., Randomized phase III trial of temsirolimus versus sorafenib as second-line therapy after sunitinib in patients with metastatic renal cell carcinoma (2014) J Clin Oncol, 32, pp. 760-767; Iacovelli, R., Santoni, M., Verzoni, E., Grassi, P., Testa, I., De Braud, F., Everolimus and temsirolimus are not the same second-line in metastatic renal cell carcinoma. A systematic review and meta-analysis of literature data (2015) Clin Genitourin Cancer, 13, pp. 137-141; Motzer, R.J., Escudier, B., McDermott, D.F., George, S., Hammers, H.J., Srinivas, S., Nivolumab versus everolimus in advanced renal-cell carcinoma (2015) N Engl J Med, 373, pp. 1803-1813; Choueiri, T.K., Escudier, B., Powles, T., Mainwaring, P.N., Rini, B.I., Donskov, F., Cabozantinib versus everolimus in advanced renal-cell carcinoma (2015) N Engl J Med, 373, pp. 1814-1823; Powles, T., Staehler, M., Ljungberg, B., Bensalah, K., Canfield, S.E., Dabestani, S., European Association of Urology guidelines for clear cell renal cancers that are resistant to vascular endothelial growth factor receptor-targeted therapy (2016) Eur Urol, 70, pp. 705-706; Escudier, B., Porta, C., Schmidinger, M., Rioux-Leclercq, N., Bex, A., Khoo, V., Renal cell carcinoma: ESMO Clinical Practice guidelines for diagnosis, treatment and follow-up (2016) Ann Oncol, 27, pp. v58-v68; Derosa, L., Guida, A., Albiges, L., Massard, C., Loriot, Y., Biasco, E., New prognostic factors for second-line targeted therapy (TT) metastatic renal cell carcinoma (mRCC) (2015) Ann Oncol, 26, p. vi53

PY - 2018

Y1 - 2018

N2 - We aimed to investigate the different outcomes in patients with metastatic renal cell carcinoma treated with second-line axitinib or everolimus after sunitinib. Patients treated in 16 oncological centres in Italy were included, and those receiving axitinib or everolimus from January 2013 onwards were analysed for outcomes. Descriptive statistical tests were used to highlight differences between groups. The Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS). Data on 634 patients with metastatic renal cell carcinoma treated with first-line sunitinib have been obtained. A total of 182 patients received a second-line therapy with everolimus (79 patients, 43%) or axitinib (103 patients, 57%), respectively. The median PFS was 4.6 [95% confidence (CI): 2.6-6.5] months for patients treated with everolimus and 5.5 (95% CI: 4.3-6.7) months for patients treated with axitinib (P=0.7). The median OS was 13.9 (95% CI: 10.4-17.4) months for patients treated with everolimus and 12.0 (95% CI: 7.9-16.2) months for patients treated with axitinib (P=0.3). No differences were found based on length of first-line treatment. Major limitations are the retrospective nature of the study and the lack of a prospective evaluation of the progression. This study reports no significantly differences between everolimus and axitinib in terms of both PFS and OS. Furthermore, the length of first-line treatment cannot be used as such a predictive factor and cannot suggest the use of a molecule compared with another. © 2018 Wolters Kluwer Health, Inc. All rights reserved.

AB - We aimed to investigate the different outcomes in patients with metastatic renal cell carcinoma treated with second-line axitinib or everolimus after sunitinib. Patients treated in 16 oncological centres in Italy were included, and those receiving axitinib or everolimus from January 2013 onwards were analysed for outcomes. Descriptive statistical tests were used to highlight differences between groups. The Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS). Data on 634 patients with metastatic renal cell carcinoma treated with first-line sunitinib have been obtained. A total of 182 patients received a second-line therapy with everolimus (79 patients, 43%) or axitinib (103 patients, 57%), respectively. The median PFS was 4.6 [95% confidence (CI): 2.6-6.5] months for patients treated with everolimus and 5.5 (95% CI: 4.3-6.7) months for patients treated with axitinib (P=0.7). The median OS was 13.9 (95% CI: 10.4-17.4) months for patients treated with everolimus and 12.0 (95% CI: 7.9-16.2) months for patients treated with axitinib (P=0.3). No differences were found based on length of first-line treatment. Major limitations are the retrospective nature of the study and the lack of a prospective evaluation of the progression. This study reports no significantly differences between everolimus and axitinib in terms of both PFS and OS. Furthermore, the length of first-line treatment cannot be used as such a predictive factor and cannot suggest the use of a molecule compared with another. © 2018 Wolters Kluwer Health, Inc. All rights reserved.

KW - axitinib

KW - everolimus

KW - mammalian target of rapamycin

KW - metastatic renal cell carcinoma

KW - second-line

KW - sequence

KW - sunitinib

KW - tyrosine kinase inhibitor

KW - adult

KW - Article

KW - cancer chemotherapy

KW - cancer surgery

KW - cancer survival

KW - clinical outcome

KW - disease exacerbation

KW - female

KW - follow up

KW - human

KW - kidney metastasis

KW - major clinical study

KW - male

KW - middle aged

KW - nephrectomy

KW - overall survival

KW - priority journal

KW - progression free survival

KW - renal cell carcinoma

KW - treatment outcome

U2 - 10.1097/CAD.0000000000000632

DO - 10.1097/CAD.0000000000000632

M3 - Article

VL - 29

SP - 705

EP - 709

JO - Anti-Cancer Drugs

JF - Anti-Cancer Drugs

SN - 0959-4973

IS - 7

ER -