Sunitinib, pazopanib or sorafenib for the treatment of patients with late relapsing metastatic renal cell carcinoma

J Urol. 2015 Jan;193(1):41-7. doi: 10.1016/j.juro.2014.07.011. Epub 2014 Jul 18.


Purpose: Late recurrence of renal cell carcinoma is not a rare event. In this retrospective study we investigate the clinicopathological features and the outcome of patients treated with sorafenib, sunitinib and pazopanib for late relapsing renal cell carcinoma.

Materials and methods: Data were collected from 21 Italian centers involved in the treatment of metastatic renal cell carcinoma. Late relapse was defined as more than 5 years after initial radical nephrectomy.

Results: A total of 2,490 patients were screened and 269 (11%) were included in the study. First line therapy was sunitinib in 190 patients (71%), sorafenib in 58 (21%) and pazopanib in 21 (8%). Median progression-free survival was 20.0 months for sunitinib (95% CI 17.0-25.1), and 14.1 months for sorafenib (95% CI 11.0-29.0) and pazopanib (95% CI 11.2-not reported). On multivariate analysis MSKCC score and metastases to lymph nodes, liver and brain were associated with worst overall survival, while pancreatic metastases were associated with longer survival. Furthermore, age, MSKCC score and brain metastases were associated with worst progression-free survival.

Conclusions: Patients with late relapsing renal cell carcinoma seem to present a characteristic pattern of metastatic spread without showing significant differences in terms of progression-free survival among sorafenib, sunitinib and pazopanib.

Keywords: carcinoma; protein-tyrosine kinases; recurrence; renal cell; survival.

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / secondary*
  • Female
  • Humans
  • Indazoles
  • Indoles / therapeutic use*
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / pathology*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Niacinamide / analogs & derivatives*
  • Niacinamide / therapeutic use
  • Phenylurea Compounds / therapeutic use*
  • Pyrimidines / therapeutic use*
  • Pyrroles / therapeutic use*
  • Retrospective Studies
  • Sorafenib
  • Sulfonamides / therapeutic use*
  • Sunitinib


  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Indazoles
  • Indoles
  • Phenylurea Compounds
  • Pyrimidines
  • Pyrroles
  • Sulfonamides
  • Niacinamide
  • pazopanib
  • Sorafenib
  • Sunitinib