Motzer RJ et al. (2007) Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med 356: 115–124
Patients with metastatic renal cell carcinoma (RCC) have low rates of response (5–20%) to first-line therapy with interleukin 2 or interferon α; median overall survival is approximately 12 months. The multityrosine kinase inhibitor sunitinib malate targets the overexpression of vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR) that occurs in many cases of RCC through inactivation of the VHL gene, and has shown promise in cytokine-resistant patients. Data from a phase III trial provide further evidence that angiogenic inhibition is promising as a treatment strategy for clear-cell RCC.
Motzer et al. randomized 750 patients with metastatic clear-cell RCC to first-line treatment with sunitinib (50 mg orally once daily for 4 weeks, then 2 weeks without treatment, in 6-week cycles) or interferon α (titrated to 9 MU subcutaneously 3 times a week). Patients in the sunitinib group had significantly longer median progression-free survival than those on interferon α (11 vs 5 months; P <0.001). Sunitinib also resulted in a significantly increased objective response rate (31% vs 6%; P <0.001). Symptoms including diarrhea and grade 3 or 4 neutropenia were more frequently reported in the sunitinib group, but patients on this treatment reported a significantly better quality of life than did patients on interferon α (P <0.001), and most adverse events resolved upon dose interruption or modification. Long-term data are needed to clarify issues such as the role of angiogenic growth factors in metastatic RCC, and the relative survival benefits of sunitinib and interleukin 2.
Change history
17 May 2018
This article was published with the same DOI as a previous publication. A new DOI has been assigned and registered at Crossref, and has been corrected in the article.
Rights and permissions
About this article
Cite this article
Sunitinib improves response and survival rates in metastatic RCC. Nat Rev Urol 4, 181 (2007). https://doi.org/10.1038/ncponc0762x
Issue Date:
DOI: https://doi.org/10.1038/ncponc0762x