Abstract
BackgroundPazopanib is indicated in the first-line treatment of metastatic renal cell cancer (mRCC). The aim of this study was to review the efficacy, safety, and pharmacokinetics of pazopanib and see how these aspects are linked to clinical practice.MethodsA non-exhaustive systematic review was conducted according to the three topics. No publication restrictions were imposed and the selected languages were Spanish and English. After that, a summary of the main results and findings of the review was presented and discussed during three meetings (one for each topic) with 13 medical oncologists that usually treat mRCC. At these meetings, a questionnaire on the first-line use of pazopanib in clinical practice was also drawn up. After the meetings, the questionnaire was completed by 60 specialist medical oncologists in renal cancer.ResultsThe efficacy and safety of pazopanib have been demonstrated in several clinical trials, and subsequently confirmed in studies in real-world clinical practice. In addition to its clinical benefit and good safety profile, quality of life results for pazopanib, which compare favorably to sunitinib, make it a good option in the first-line treatment of patients. Special populations have been included in studies conducted with pazopanib, and it is safe for use in elderly patients, poor functional status, kidney failure, and mild or moderate hepatic impairment, and in patients with concomitant cardiovascular disease. The results of the questionnaire have shown that pazopanib is perceived as an effective drug, in which quality of life (QoL) outcomes are valued above all.ConclusionsThis paper offers a comprehensive and critical summary of efficacy, tolerability, and pharmacokinetics of pazopanib in the treatment of mRCC. Pazopanib is an effective treatment with an acceptable safety profile. Its QoL and tolerability results offer certain advantages when compared with other therapeutic alternatives, and its use appears to be safe in different patient profiles.
Highlights
Pazopanib is indicated in the first-line treatment of metastatic renal cell cancer
Pazopanib efficacy Progression-free survival Evidence on the effectiveness of pazopanib in the first-line treatment of metastatic renal cell cancer (mRCC) has been obtained from several clinical trials which have shown a progression-free survival (PFS) of between 8 and 11 months, either compared to placebo or to sunitinib [14, 24]
Response rates based on the independent evaluations performed in the VEG105192 and the COMPARZ studies were significantly superior to those obtained with placebo and sunitinib, respectively
Summary
Pazopanib is indicated in the first-line treatment of metastatic renal cell cancer (mRCC). Renal cancer accounts for 2% of all cancers diagnosed in adults, the incidence is higher in developed countries. The most common kidney cancer in adults is renal cell carcinoma (RCC), which accounts for 90% of malignant kidney tumors; of these, an estimated 80–85% are clear cell tumors. Despite curative surgery of the localized tumor, it is estimated that approximately 30% of patients will subsequently develop metastatic disease [5]. Clear cell RCC are highly vascularized tumors that accumulate lipid and glycogen [6,7,8]. Tyrosine kinase inhibitors (TKI) and mTOR inhibitors are therapeutic options in first-, second- and third-line treatment in patients with metastatic RCC (mRCC) [6, 10,11,12]
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