Metastatic Renal Cell Carcinoma Clinical Trial
Official title:
Validation of the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) Prognostic Classification for Targeted Therapies (TKI/mTOR Inhibitors) in Second Line After First Line Treatment With Pazopanib
This is a nation-wide retrospective observational study which will be performed in 50 centres
in Spain, geographically representative of all regions, with at least 5 patients treated with
first-line pazopanib for mRCC in daily clinical practice since April 2011 (date of approval
of pazopanib in Spain), January 2016.
Pazopanib is one of the standard tyrosine-kinase inhibitors (TKI) for the first-line
treatment of metastatic renal cell carcinoma. In our previous SPAZO study, the Spanish
Oncologic Genitourinary Group (SOGUG) validated the IMDC prognostic classification for
patients receiving first-line pazopanib, and demonstrated the effectiveness of this drug in
routine clinical practice. However, in this series of 278 patients, we could not obtain
enough information on the effectiveness of pazopanib in special subpopulations such as
non-clear cell histologies, and others subgroups, due to a small simple size of each of these
subpopulations. On the other hand, after the results of RECORD-1 and AXIS trials, switching
to everolimus or axitinib is the current approach for patients who progresses to a first-line
TKI. However, these pivotal studies did not include patients treated with first-line
pazopanib study because this drug was not available at that time. The results of the SPAZO
study also suggested that the effectiveness of second-line targeted therapies (TT) after
pazopanib in routine clinical practice is similar to the observed in clinical trials after
sunitinib, sorafenib or bevacizumab. In addition, the preliminary results indicated that
there are not meaningful differences in the effectiveness of TKI or mTOR inhibitors after
pazopanib, when the results are adjusted by the IMDC prognostic classification. However, the
IMDC prognostic classification for second-line TT has not yet been validated for patients who
receive pazopanib as first-line. In addition our sample size was not large enough to make a
comparison of effectiveness between mTOR inhibitors and antiVEGF for each prognostic
subgroups of the IMDC.
Based on that, the Spanish Oncologic Genitourinary Group has decided to launch the SPAZO-2
study, in which we intend to prolong the follow up of patients included in SPAZO, and to
increase the sample size with new patients from new centres, in order to obtain a larger
sample in each of the subpopulations of interest, with the objective of obtaining more
information about the above questions.
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