Sequential therapy with sorafenib and sunitinib in renal cell carcinoma

Arkadiusz Z. Dudek, Jakub Zolnierek, Anu Dham, Bruce R. Lindgren, Cezary Szczylik

Research output: Contribution to journalArticlepeer-review

164 Scopus citations


BACKGROUND: Sunitinib and sorafenib are small-molecule tyrosine kinase inhibitors (TKI) with antitumor activity in advanced renal cell carcinoma. A retrospective study was conducted to assess the response of renal cell carcinoma to sequential treatment with these two agents. METHODS: Tumor response was evaluated by using Response Evaluation Criteria In Solid Tumors (RECIST) criteria in patients failing first-line therapy with either sunitinib or sorafenib and subsequently receiving second-line therapy with the other TKI agent. RESULTS: Twenty-nine patients received sorafenib followed by sunitinib (Group A), and 20 patients received sunitinib followed by sorafenib (Group B). TKI drugs were terminated in 6 (12%) patients in Group A and 4 (8%) in Group B because of toxicity. Median duration of stable disease for Groups A and B was 20 and 9.5 weeks, respectively. Median time from starting first TKI to disease progression after second TKI (time to progression) in Groups A and B was 78 and 37 weeks, respectively. Multivariate analysis revealed that Group B had a shorter time to progression than Group A (risk ratio [RR] 3.0; P=.016). Median overall survival was 102 and 45 weeks in Groups A and B, respectively (P=.061). CONCLUSIONS: The longer duration of disease control in patients who received sorafenib followed by sunitinib warrants further investigation.

Original languageEnglish (US)
Pages (from-to)61-67
Number of pages7
Issue number1
StatePublished - Jan 1 2009


  • Renal cell carcinoma
  • Sequential therapy
  • Sorafenib
  • Sunitinib
  • Tyrosine kinase inhibition


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