PMID- 31122210
OWN - NLM
STAT- MEDLINE
DCOM- 20191211
LR  - 20211204
IS  - 1471-2407 (Electronic)
IS  - 1471-2407 (Linking)
VI  - 19
IP  - 1
DP  - 2019 May 23
TI  - Pazopanib has equivalent anti-tumor effectiveness and lower Total costs than 
      Sunitinib for treating metastatic or advanced renal cell carcinoma: a 
      meta-analysis.
PG  - 489
LID - 10.1186/s12885-019-5704-3 [doi]
LID - 489
AB  - BACKGROUND: Sunitinib and pazopanib are extensively used as first-line treatment 
      of metastatic renal cell carcinoma (mRCC). We performed this meta-analysis to 
      assess the anti-tumor effectiveness, toxicity, and total costs of the two drugs 
      among patients with mRCC/advanced RCC (aRCC). MATERIALS AND METHODS: PubMed, 
      ScienceDirect, Scopus, Web of Science, Ovid MEDLINE, the Cochrane Library, 
      Embase, and Google Scholar were searched to obtain eligible articles. The 
      endpoints included progression-free survival (PFS), overall survival (OS), 
      adverse effects (AEs), and per-patient-per-month (PPPM) costs. RESULTS: We 
      included 14 medium- to high-quality studies. Both drugs were valid for mRCC/aRCC, 
      with equivalent PFS (hazard ratio (HR) =1.06, 95% confidence interval [CI]: 
      0.98-1.15, P = 0.13), OS (HR = 0.92, 95% CI: 0.79-1.07, P = 0.29), objective 
      response rate (ORR, risk ratio (RR) =1.03, 95% CI: 0.93-1.13, p = 0.58), and 
      disease control rate (DCR, RR = 1.03, 95% CI: 0.94-1.22, P = 0.54). Sunitinib had 
      more dosage reductions and higher PPPM (weighted mean difference = - 1.50 
      thousand US dollars, 95% CI: - 2.27 to - 0.72, P = 0.0002). Furthermore, more 
      incidences of severe fatigue, thrombocytopenia, and neutropenia were recorded for 
      sunitinib, but pazopanib had more liver toxicity. In subgroup analysis, studies 
      from the US reported longer OS (HR = 0.86, 95% CI: 0.77-0.95, P = 0.004) and 
      higher ORR (RR = 1.24, 95% CI: 1.03-1.51, P = 0.03). CONCLUSIONS: Pazopanib 
      provides equivalent anti-tumor effectiveness and lower PPPM as compared with 
      sunitinib for mRCC/aRCC. Great care should be given to pazopanib-treated patients 
      with abnormal liver function. Nevertheless, more large-scale, high-quality 
      studies are required.
FAU - Deng, Huan
AU  - Deng H
AD  - Department of Thoracic Surgery, The First Affiliated Hospital of Nanchang 
      University, Minde Rd, Nanchang, 330006, Jiangxi Province, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
FAU - Huang, Yu
AU  - Huang Y
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, 330006, China.
FAU - Hong, Zhengdong
AU  - Hong Z
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, 330006, China.
FAU - Yuan, Xuhui
AU  - Yuan X
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, 330006, China.
FAU - Cao, Zhi
AU  - Cao Z
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, 330006, China.
FAU - Wei, Yiping
AU  - Wei Y
AD  - Department of Thoracic Surgery, The First Affiliated Hospital of Nanchang 
      University, Minde Rd, Nanchang, 330006, Jiangxi Province, China.
FAU - Zhang, Wenxiong
AU  - Zhang W
AUID- ORCID: 0000-0003-2962-0847
AD  - Department of Thoracic Surgery, The First Affiliated Hospital of Nanchang 
      University, Minde Rd, Nanchang, 330006, Jiangxi Province, China. 
      zwx123dr@126.com.
LA  - eng
GR  - 81560345/National Natural Science Foundation of China/
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20190523
PL  - England
TA  - BMC Cancer
JT  - BMC cancer
JID - 100967800
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Indazoles)
RN  - 0 (Pyrimidines)
RN  - 0 (Sulfonamides)
RN  - 7RN5DR86CK (pazopanib)
RN  - V99T50803M (Sunitinib)
SB  - IM
MH  - Aged
MH  - Antineoplastic Agents/*adverse effects/economics/*therapeutic use
MH  - Carcinoma, Renal Cell/*drug therapy
MH  - Fatigue/etiology
MH  - Health Care Costs
MH  - Humans
MH  - Indazoles
MH  - Kidney Neoplasms/*drug therapy
MH  - Liver/drug effects
MH  - Middle Aged
MH  - Neutropenia/etiology
MH  - Pyrimidines/*adverse effects/economics/*therapeutic use
MH  - Retrospective Studies
MH  - Sulfonamides/*adverse effects/economics/*therapeutic use
MH  - Sunitinib/*adverse effects/economics/*therapeutic use
MH  - Thrombocytopenia/etiology
MH  - Treatment Outcome
PMC - PMC6533682
OTO - NOTNLM
OT  - Meta-analysis
OT  - Pazopanib
OT  - Renal cell carcinoma
OT  - Sunitinib
OT  - Targeted therapy
COIS- The authors declare that they have no competing interests.
EDAT- 2019/05/28 06:00
MHDA- 2019/12/18 06:00
PMCR- 2019/05/23
CRDT- 2019/05/25 06:00
PHST- 2018/11/29 00:00 [received]
PHST- 2019/05/10 00:00 [accepted]
PHST- 2019/05/25 06:00 [entrez]
PHST- 2019/05/28 06:00 [pubmed]
PHST- 2019/12/18 06:00 [medline]
PHST- 2019/05/23 00:00 [pmc-release]
AID - 10.1186/s12885-019-5704-3 [pii]
AID - 5704 [pii]
AID - 10.1186/s12885-019-5704-3 [doi]
PST - epublish
SO  - BMC Cancer. 2019 May 23;19(1):489. doi: 10.1186/s12885-019-5704-3.