title: First line treatment of metastatic renal cell carcinoma: two standards with different toxicity profile.
abstract: Tyrosine kinase inhibitors are de facto the more used targeted therapies for upfront treatment of metastatic renal cell carcinoma (mRCC). Among these, sunitinib and pazopanib have reported greater activity in term of progression-free survival and overall survival compared with interferon-α or placebo in two independent large phase III studies. Despite a large use in clinical practice these molecules had never been compared. The COMPARZ study recently published in the New England Journal of Medicine reports the results of a non-inferiority trial that comparing pazopanib to sunitinib as first line of therapy in mRCC patients. Here we report the activity and safety data of the study and we discuss several critical aspects related to the study design and possible confounding factors that may alter the results' interpretation.
authors.affiliation: Department of Medical Oncology; Fondazione IRCCS Istituto Nazionale Tumori; Milano, Italy; Department of Radiology, Oncology and Human Pathology PhD program; Sapienza University of Rome; Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Iacovelli
authors.affiliation: Department of Medical Oncology; Fondazione IRCCS Istituto Nazionale Tumori; Milano, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Verzoni
authors.affiliation: Department of Medical Oncology; Fondazione IRCCS Istituto Nazionale Tumori; Milano, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: De Braud
authors.affiliation: Department of Medical Oncology; Fondazione IRCCS Istituto Nazionale Tumori; Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008297:Male; D011743:Pyrimidines / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*
chemical_list: D020533:Angiogenesis Inhibitors; D007211:Indoles; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides
keywords: first line; non-inferiority study; pazopanib; phase III trial; renal cancer; sunitinib; toxicity