- Sorafenib followed by pazopanib (sorafenib-pazopanib) failed to demonstrate noninferiority vs the reverse (pazopanib-sorafenib) as first-line therapy for metastatic renal cell carcinoma (mRCC).
- The pazopanib-sorafenib sequence was associated with longer PFS.
Why this matters
- Multiple trials are exploring optimal treatment combinations and sequences for advanced renal cancer.
- Multicenter, randomized phase 3 SWITCH II study.
- 377 patients without prior systemic therapy for mRCC were randomly assigned to sorafenib-pazopanib or pazopanib-sorafenib; treatment continued until progression or unacceptable toxicity.
- Funding: Technical University of Munich, Germany; Bayer HealthCare GmbH.
- Noninferiority not met for total PFS of sequence sorafenib-pazopanib vs pazopanib-sorafenib (median, 8.6 vs 12.9 months; HR, 1.36 [upper limit of one-sided 95% CI was greater than predefined HR
- Median OS for pazopanib-sorafenib was 28.0 vs 22.7 months for sorafenib-pazopanib (HR, 1.22; P=.2842).
- With sorafenib-pazopanib vs pazopanib-sorafenib:
- Median PFS after first-line therapy was 5.6 vs 9.3 months.
- Median PFS after second-line therapy was 2.9 vs 2.1 months.
- Most frequent TEAEs were gastrointestinal disorders:
- First-line sorafenib vs pazopanib (80.3% vs 79.8%).
- Second-line pazopanib vs sorafenib (55.7% vs 57.5%).
- Slow patient accrual.