Non-clear cell renal cell carcinoma (RCC) and sarcomatoid renal cell carcinoma are often treated similarly to clear cell RCC with the tyrosine kinase inhibitors, sunitinib and pazopanib. A recent study investigated the effectiveness of these two drugs for the first-line treatment of metastatic non-clear cell and sarcomatoid RCC.
Of the 53 patients included in the study, 16 (30.1%) were treated with sunitinib and 37 (69.9%) with pazopanib. Forty-six (86.8%) patients had non-clear cell RCC and 7 (13.2%) had sarcomatoid RCC. The majority of patients (93%) had intermediate or poor risk RCC.
Median progression-free survival was 6.6 months with sunitinib and 4.9 months with pazopanib. Median overall survival was 30.4 months with sunitinib and 8.7 months with pazopanib. For a subgroup of patients with with papillary, chromophobe and MiT family translocation RCC, median overall survival with sunitinib treatment was 38.7 months versus 14.7 months for pazopanib. Unclassified and sarcomatoid RCC had lower median overall survival of 6.9 and 1.1 months, respectively, regardless of the treatment used.
In conclusion, in patients with metastatic non-clear cell RCC, treatment with sunitinib was associated with a longer overall survival than treatment with pazopanib. Larger trials are needed to confirm these results.