Safety and treatment outcomes of first-line pazopanib in renal cell carcinoma: A prospective observational study in a single Malaysia tertiary hospital

Azmi Nor Mohd Farez Ahmat, Nik Nuradlina Nik Adnan, Nurul Suhaida Badarudin, Beng Ho Chong, Amirah Mohd Zaki, Mohd Naqib Zainal Abidin, Leong Shean Lee, Shirley Tang, Sri Devi a/p Ayavoo, Gerard Chin Chye Lim, Rozita Mohamad

Abstract


Introduction: Pazopanib is the standard of care for metastatic renal cell carcinoma (mRCC). Previous studies on this indication were limited to patients who were selected on the basis of a fairly preserved performance status and normal organ function. Thus, the clinical trial population may not be representative of all patients seen in real-world practice. Based on these considerations, this prospective single-centre observational study was designed to evaluate the treatment outcomes and safety profile of pazopanib in Malaysian population. Patients and methods: Patients prescribed with pazopanib between June 2015 and June 2017 were recruited and followed up for 2-years or till death whichever comes first. Progression-free survival (PFS) and overall survival (OS) were evaluated. Multivariate and survival analysis were performed. Results: Twenty-seven patients were treated with pazopanib where 89% had clear cell histology.  Sixteen patients (59%) were intermediate risk and 41% were poor risk based on Memorial Sloan Kettering Cancer Center (MSKCC) criteria. All patients experienced at least one adverse event. The most common were cutaneous toxicity (92%) followed by proteinuria, hypertension, diarrhoea and mucositis. Treatment interruption was needed in 15 patients. The median PFS and OS were 9.57 months and 15.5 months, respectively. In multivariate analysis, MSKCC risk score demonstrates strong predictive treatment outcome. The median PFS was 14.5 months in intermediate risk and 3.96 months in poor risk (OR: 0.2, p<0.001). However, the median OS is still immature to be reported since 63% of intermediate risk group is still alive at 2-years follow-up. Conclusion: In mRCC patients, treatment with pazopanib was effective in patients with intermediate risk group. In terms of safety, patient tolerated pazopanib quite well with mostly experienced grade 1 to 2 adverse events.

Keywords


metastatic renal cell carcinoma; pazopanib; VEGF-TKI; survival; outcome

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DOI: http://dx.doi.org/10.30564/amor.v3i6.143

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Copyright (c) 2018 Azmi Nor Mohd Farez Ahmat, Nik Nuradlina Nik Adnan, Nurul Suhaida Badarudin, Beng Ho Chong, Amirah Mohd Zaki, Mohd Naqib Zainal Abidin, Leong Shean Lee, Shirley Tang, Sri Devi a/p Ayavoo, Gerard Chin Chye Lim, Rozita Mohamad

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