New treatments slow progression of metastatic kidney cancer

NEW YORK (Reuters Health) - Recent treatment regimens for metastatic renal cell cancer using agents such as sunitinib, which targets VEGF, appear to offer an increase in progression-free survival, according to a meta-analysis conducted by Canadian and UK investigators.

Lead investigator Dr. Edward J. Mills told Reuters Health, "This study demonstrates the obvious effectiveness of new interventions for metastatic renal cell cancer."

In a January 27th online publication in BMC Cancer, Dr. Mills of McMaster University, Hamilton, and colleagues report on their analysis of data from seven trials involving almost 4000 patients. The agents employed were bevacizumab with or without interferon-alpha, sorafenib, sunitinib, and temsirolimus.

All treatments showed progression-free survival advantages. In the absence of head-to-head trials, the researchers used indirect comparison to evaluate their effects compared to those with interferon-alpha.

Sunitinib was superior to sorafenib (hazard ratio, 0.58) and bevacizumab with interferon-alpha (hazard ratio, 0.75). Results with sorafenib were not statistically different from those bevacizumab and interferon-alpha.

Compared to placebo, there were no significant differences between sorafenib and bevacizumab alone. In patients with a poor prognosis, temsirolimus provided a significant improvement in progression-free survival (hazard ratio, 0.69).

The researchers point out that although effective, these drugs are particularly expensive.

Nevertheless, given the superiority of the agents, continued Dr. Mills, "the public should now be concerned with whether they will be able to access these interventions due to their cost and whether their local health agencies are willing to cover such costs."

"It demonstrates," he concluded, "the challenges of linking clinically effective drugs with the end users, the patients themselves."

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