Pazopanib has equivalent anti-tumor effectiveness and lower Total costs than Sunitinib for treating metastatic or advanced renal cell carcinoma: a meta-analysis.

ABSTRACT: BACKGROUND:Sunitinib and pazopanib are extensively used as first-line treatment of metastatic renal cell carcinoma (mRCC). We performed this meta-analysis to assess the anti-tumor effectiveness, toxicity, and total costs of the two drugs among patients with mRCC/advanced RCC (aRCC). MATERIALS AND METHODS:PubMed, ScienceDirect, Scopus, Web of Science, Ovid MEDLINE, the Cochrane Library, Embase, and Google Scholar were searched to obtain eligible articles. The endpoints included progression-free survival (PFS), overall survival (OS), adverse effects (AEs), and per-patient-per-month (PPPM) costs. RESULTS:We included 14 medium- to high-quality studies. Both drugs were valid for mRCC/aRCC, with equivalent PFS (hazard ratio (HR) =1.06, 95% confidence interval [CI]: 0.98-1.15, P?=?0.13), OS (HR?=?0.92, 95% CI: 0.79-1.07, P?=?0.29), objective response rate (ORR, risk ratio (RR) =1.03, 95% CI: 0.93-1.13, p?=?0.58), and disease control rate (DCR, RR?=?1.03, 95% CI: 0.94-1.22, P?=?0.54). Sunitinib had more dosage reductions and higher PPPM (weighted mean difference?=?-?1.50 thousand US dollars, 95% CI: -?2.27 to -?0.72, P?=?0.0002). Furthermore, more incidences of severe fatigue, thrombocytopenia, and neutropenia were recorded for sunitinib, but pazopanib had more liver toxicity. In subgroup analysis, studies from the US reported longer OS (HR?=?0.86, 95% CI: 0.77-0.95, P?=?0.004) and higher ORR (RR?=?1.24, 95% CI: 1.03-1.51, P?=?0.03). CONCLUSIONS:Pazopanib provides equivalent anti-tumor effectiveness and lower PPPM as compared with sunitinib for mRCC/aRCC. Great care should be given to pazopanib-treated patients with abnormal liver function. Nevertheless, more large-scale, high-quality studies are required.

SUBMITTER: Deng H 

PROVIDER: S-EPMC6533682 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature