Pazopanib as a possible option for the treatment of metastatic non-clear cell renal carcinoma patients: a systematic review

Background: Effective systemic treatment of non-clear cell renal carcinoma (nccRCC) is still an unmet clinical need, with few studies to support an evidence-based approach. To date, the only recommended standard first-line treatment is sunitinib. Pazopanib may also be used in nccRCC but its place in therapy is not clearly established. It has comparable efficacy and better tolerability than sunitinib in clear cell renal carcinoma. Our objective was to review the use of pazopanib in metastatic nccRCC. Methods: We conducted a systematic review according to PRISMA guidelines. Any type of study reporting the use of pazopanib in metastatic renal cell carcinoma including cases with non-clear cell histology was eligible. Results: In all, 15 studies were included in our analysis, including a total of 318 nccRCC patients treated with pazopanib. Most studies were retrospective ( n = 12); three were prospective trials. The specific outcomes of nccRCC patients were reported by four studies. Pazopanib alone as first-line treatment gave overall response rates ranging from 27% to 33%, disease control rates of 81–89%, median progression free survival of 8.1–16.5 months and median overall survival of 17.3–31.0 months. Grade 3–4 adverse events rates were 21–55%. Conclusion: The present review provides for the first time a systematic summary of evidence about the possible use of pazopanib as first-line treatment for nccRCC, with a favorable outcome despite the low strength of evidence. Pazopanib could be considered as a possible therapeutic option in this setting.

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First-line PAzopanib in NOn-clear cell Renal cArcinoMA: the Italian retrospective multicenter PANORAMA study

Annals of Oncology ◽

10.1093/annonc/mdw373.59 ◽

2016 ◽

Vol 27 ◽

pp. vi290 ◽

Cited By ~ 1

Author(s):

M. Bersanelli ◽

F. Maines ◽

G. Facchini ◽

F. Gelsomino ◽

F. Zustovich ◽

...

Keyword(s):

Renal Carcinoma ◽

Clear Cell ◽

Clear Cell Renal Carcinoma ◽

First Line ◽

Cell Renal Carcinoma

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Renal cancer treatment in Spain: An online survey.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.397 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 397-397

Author(s):

I. Duran ◽

P. Sanchez Maurino ◽

J. Garcia-Donas ◽

D. R. Berthold

Keyword(s):

Renal Cancer ◽

Mechanism Of Action ◽

Online Survey ◽

Renal Carcinoma ◽

Mtor Inhibitor ◽

Clear Cell ◽

Therapeutic Options ◽

Line Treatment ◽

First Line ◽

First Line Treatment

397 Background: Renal cancer incidence has increased in the last decades. Many treatment options have also been developed in this period. Knowledge about oncologists' attitudes in the management of this disease could help to implement better treatment protocols. Methods: An online survey about therapeutic options for renal cancer was developed by an expert committee. Oncologists with expertise on the treatment of genitourinary malignancies that fulfilled all inclusion criteria in Spain were listed (n=200) and 80 were randomly selected to complete the survey. Survey items considered renal carcinoma management in the daily clinical practice. The questionnaire posed multiple tests, protocols, or therapeutic options. Results: From the 80 selected oncologists, 53 responded to the online survey (66% response rate). The mean number of newly diagnosed cases per year was 201 (SD: 12) patients of whom 15 corresponded to renal carcinoma. Seventy nine per cent of participants reported to apply a protocol for treatment decisions, being the NCCN recommendations the most frequently followed (54.7%). Surprisingly, local or European recommendations were scarcely used. When asked about management of metastatic disease, most physicians (83%) reported that they would use sunitinib as the preferred first line treatment for good or intermediate prognosis patients. If further treatment would be required, 69.8% (n=37) and 79.2% (n=42) of oncologists would recommend a change in the mechanism of action by switching to an mTOR inhibitor (everolimus) for first and further relapses, respectively. Regarding the management of first line non-clear cell histologies, almost half of the physicians would utilize a TKI, while 38% would prefer an mTOR inhibitor. Conclusions: NCCN are the most frequently followed recommendations. There is agreement among oncologists about which treatment should be used for renal carcinoma after first line treatment failure by switching the mechanism of action of the selected treatment. The management of non-clear cell patients remains a matter of debate with no consensus among the participants. No significant financial relationships to disclose.

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First-line PAzopanib in NOn-clear cell Renal cArcinoMA: the Italian retrospective multicenter PANORAMA study

Annals of Oncology ◽

10.1093/annonc/mdw334.10 ◽

2016 ◽

Vol 27 ◽

pp. iv32

Author(s):

M. Bersanelli ◽

F. Maines ◽

G. Facchini ◽

F. Gelsomino ◽

F. Zustovich ◽

...

Keyword(s):

Renal Carcinoma ◽

Clear Cell ◽

Clear Cell Renal Carcinoma ◽

First Line ◽

Cell Renal Carcinoma

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Tyrosine kinase inhibitors in the first-line treatment for metastatic nonclear cell renal carcinoma: A retrospective analysis of a national database

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2018.12.017 ◽

2019 ◽

Vol 37 (4) ◽

pp. 294.e1-294.e8 ◽

Cited By ~ 2

Author(s):

Alexandr Poprach ◽

Kristina Rumanova ◽

Radek Lakomý ◽

Renata Chloupková ◽

Michal Stanik ◽

...

Keyword(s):

Tyrosine Kinase ◽

Retrospective Analysis ◽

Tyrosine Kinase Inhibitors ◽

Renal Carcinoma ◽

Kinase Inhibitors ◽

National Database ◽

Line Treatment ◽

First Line ◽

Cell Renal Carcinoma ◽

First Line Treatment

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The role of STAT3 protein as a prognostic factor in the clear cell renal carcinoma. Systematic review

Actas Urológicas Españolas (English Edition) ◽

10.1016/j.acuroe.2019.02.006 ◽

2019 ◽

Vol 43 (3) ◽

pp. 118-123

Author(s):

D. Lorente ◽

E. Trilla ◽

A. Meseguer ◽

J. Arevalo ◽

S. Nemours ◽

...

Keyword(s):

Systematic Review ◽

Prognostic Factor ◽

Renal Carcinoma ◽

Clear Cell ◽

Clear Cell Renal Carcinoma ◽

Cell Renal Carcinoma

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

World Journal of Clinical Oncology ◽

10.5306/wjco.v12.i11.1037 ◽

2021 ◽

Vol 12 (11) ◽

pp. 1037-1046

Author(s):

Sebastiano Buti ◽

Melissa Bersanelli ◽

Francesco Massari ◽

Ugo De Giorgi ◽

Orazio Caffo ◽

...

Keyword(s):

Renal Carcinoma ◽

Clear Cell ◽

Case Series ◽

Clear Cell Renal Carcinoma ◽

First Line ◽

Italian Case ◽

Cell Renal Carcinoma

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First-Line PAzopanib in NOn–clear-cell Renal cArcinoMA: The Italian Retrospective Multicenter PANORAMA Study

Clinical Genitourinary Cancer ◽

10.1016/j.clgc.2016.12.024 ◽

2017 ◽

Vol 15 (4) ◽

pp. e609-e614 ◽

Cited By ~ 17

Author(s):

Sebastiano Buti ◽

Melissa Bersanelli ◽

Francesca Maines ◽

Gaetano Facchini ◽

Francesco Gelsomino ◽

...

Keyword(s):

Renal Carcinoma ◽

Clear Cell ◽

Clear Cell Renal Carcinoma ◽

First Line ◽

Cell Renal Carcinoma

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Efficacy and tolerability of Janus kinase inhibitors in myelofibrosis: a systematic review and network meta-analysis

Blood Cancer Journal ◽

10.1038/s41408-021-00526-z ◽

2021 ◽

Vol 11 (7) ◽

Author(s):

Léa Sureau ◽

Corentin Orvain ◽

Jean-Christophe Ianotto ◽

Valérie Ugo ◽

Jean-Jacques Kiladjian ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Myeloproliferative Neoplasm ◽

Janus Kinase ◽

Comparable Efficacy ◽

Line Treatment ◽

Jak Inhibitors ◽

First Line ◽

Patient Profile ◽

First Line Treatment

AbstractMyelofibrosis is a myeloproliferative neoplasm associated with constitutional symptoms, increasing splenomegaly, and worsening cytopenias. Janus kinase (JAK) inhibitors have been used for the treatment of myelofibrosis for several years, but there is a lack of comparative information between those treatments. A systematic review and network meta-analysis was performed on randomized controlled trials in patients with myelofibrosis receiving JAK inhibitor or placebo or control. Primary outcomes were efficacy on spleen volume reduction and total symptom score reduction. Additional analyses were conducted on anemia and thrombopenia events. Seven studies were included in the network meta-analysis including 1953 patients randomly assigned to four JAK inhibitors—ruxolitinib, fedratinib, pacritinib, momelotinib—or control. In first-line therapy, momelotinib and fedratinib were associated with comparable efficacy to ruxolitinib, and with less toxicity on erythrocytes and platelets, respectively. Pacritinib was less effective on splenomegaly than ruxolitinib as a first-line treatment but seemed effective in second line, after ruxolitinib exposure. Fedratinib and ruxolitinib that are FDA approved in myelofibrosis have both confirmed being valuable option to treat splenomegaly and constitutional symptoms, and their slightly different tolerance-profiles can guide therapeutic choice for first-line treatment, according to patient profile. Momelotinib could be another option especially due to its positive effect on anemia.

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