Kidney Cancer Drug Updates

Renal cell carcinoma phase III clinical trial data presented at ESMO

(RxWiki News) At an international oncology meeting, new data has been presented on drugs that treat kidney cancer. The results have been released at the ESMO 2012 Congress of the European Society for Medical Oncology in Vienna.

This late drug trial data relates to medications used in the treatment of renal cell carcinoma, a type of cancer that starts in the lining of small tubes found in the kidney.

Data released involved these medications: bevacizumab – sold under the brand name Avastin, pazopanib (Votrient), sorafenib (Nexavar), sunitinib (Sutent), and temsirolimus (Torisel).

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Prof. Maria De Santis from Kaiser Franz Josef-Spital in Vienna, is the Chair of the ESMO 2012 Genitourinary program track (who was not involved in the studies).

He said in a press release, “At this year's ESMO congress, three urgently awaited and highly ranked randomized phase III trials in the area of renal cell carcinoma are being presented. All three studies are important, although two of these studies are so called 'negative' studies [demonstrating that the drug didn’t work well]…”

Here is a summary of what these studies found.

Pazopanib and sunitinib are essentially the same in treating metastatic renal cell carcinoma.

In the phase III l COMPARZ trial involving 1,100 people, the safety, effectiveness and quality of life impact of pazopanib was compared to the standard therapy, sunitinib.

Robert Motzer, MD from Memorial Sloan Kettering Cancer Center in New York, led the study.

Both drugs performed about the same in all areas measured, including the amount of time during which the disease didn’t get worse – progression-free survival (PFS).

The median PFS for both drugs was slightly more than 10 months. Troubling side effects – fatigue and skin sores – were less common in patients taking pazopanib than in those taking sunitinib.

Temsirolimus is not superior to sorafenib as second-line treatment

Two commonly used second-line therapies, which are used after the first therapy fails, target different molecules.

Temsirolimus targets mTOR, which directs the growth and proliferation of cell, and sorafenib blocks several enzymes called tyrosine kinases. One of those TKs is called the VEGF receptor, which attacks the blood vessels nourishing the tumor.

"This is the first head-to-head phase III trial comparing a VEGF inhibitor to an mTOR inhibitor in renal cell carcinoma, reporting final results. Hence, this trial will have important treatment implications for patients and physicians," Thomas Hutson, MD from Texas Oncology-Baylor Charles A Sammons Cancer Center in Texas, said in a news release.

The INTORSECT trial involved 511 people with renal cell carcinoma. The cancer had progressed in these individuals after they were treated first with sunitinib.

The study found that PFS (progression-free survival) was 4.28 months with temsirolimus and 3.91 months with sorafenib. And people taking temsirolimus lived a median of 12.27 months compared to 16.64 months for those who received sorafenib.

Combination of bevacizumab plus temsirolimus offers no advantage

The INTORACT trial global phase IIIb trial involved 791 people with renal cell carcinoma.

The two drugs being studied were bevacizumab and temsirolimus, which target two different types of molecules.

Researchers found a combination of bevacizumab plus temsirolimus is no better than bevacizumab plus interferon, according to Brian Rini, MD, of the Cleveland Clinic's Taussig Cancer Institute in Cleveland, Ohio and professor of medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.

Median PFS among those taking the temsirolimus combination was 9.1 months, compared to 9.3 months in the interferon group.

Median overall survival was nearly 25.8 months in the temsirolimus group and 25.5 months for the interferon group.

All research is considered preliminary before it is published in a peer-reviewed journal.

Review Date: 
September 30, 2012