PMID- 31293962
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 9
DP  - 2019
TI  - Comparative Efficacy, Safety, and Costs of Sorafenib vs. Sunitinib as First-Line 
      Therapy for Metastatic Renal Cell Carcinoma: A Systematic Review and 
      Meta-Analysis.
PG  - 479
LID - 10.3389/fonc.2019.00479 [doi]
LID - 479
AB  - Purpose: Sorafenib and sunitinib are extensively used as first-line medications 
      for metastatic renal cell carcinoma (mRCC). This meta-analysis was conducted to 
      assess the antitumor efficacy, toxicity, and costs of the two drugs among mRCC 
      patients. Materials and methods: PubMed, ScienceDirect, Scopus, Web of Science, 
      Ovid MEDLINE, the Cochrane Library, Embase, and Google Scholar were searched for 
      eligible articles. The endpoints consisted of progression-free survival (PFS), 
      overall survival (OS), objective response rate (ORR), adverse effects (AEs), and 
      per-patient-per-month (PPPM) costs. Results: We included 14 studies with 2,925 
      patients. Both drugs were valid for treating mRCC with equivalent PFS [hazard 
      ratio (HR) = 0.98, 95% confidence interval (CI): 0.88-1.10, P = 0.74] and disease 
      control rates [DCRs; risk ratio (RR) = 1.03, 95% CI: 0.98-1.08, P = 0.28], but 
      sunitinib had a better OS (HR = 1.10, 95% CI: 1.01-1.20, P = 0.04) and higher ORR 
      (HR = 0.66, 95% CI: 0.45-0.97, P = 0.03) than sorafenib. Furthermore, sunitinib 
      induced more incidences of severe hematologic AEs (anemia, neutropenia, and 
      thrombocytopenia) and stomatitis/mucositis than sorafenib. In the subanalysis, 
      Asian patients treated with sorafenib reported a longer PFS than those treated 
      with sunitinib (HR = 0.87, 95% CI: 0.83-0.90, P = 0.01), and European patients 
      treated with sunitinib had a longer OS than those treated with sorafenib (HR = 
      1.17, 95% CI: 1.01-1.30, P = 0.04). Moreover, the pooled results of the 
      high-quality studies reported a higher ORR with sunitinib than with sorafenib, 
      and medium-quality studies showed a longer OS with sunitinib than with sorafenib. 
      Conclusions: Sunitinib has more benefits (longer OS and better ORR) than 
      sorafenib as a first-line therapy for mRCC. However, sunitinib has higher 
      toxicity than sorafenib. Sorafenib might be more suitable than sunitinib among 
      Asian patients, and sunitinib might be superior to sorafenib in European 
      patients. 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, Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Liu, Wenfeng
AU  - Liu W
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - He, Ting
AU  - He T
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Hong, Zhengdong
AU  - Hong Z
AD  - Department of Urology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Yi, Fengming
AU  - Yi F
AD  - Department of Oncology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Wei, Yiping
AU  - Wei Y
AD  - Department of Thoracic Surgery, The First Affiliated Hospital of Nanchang 
      University, Nanchang, China.
FAU - Zhang, Wenxiong
AU  - Zhang W
AD  - Department of Thoracic Surgery, The First Affiliated Hospital of Nanchang 
      University, Nanchang, China.
LA  - eng
PT  - Systematic Review
DEP - 20190621
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC6598399
OTO - NOTNLM
OT  - meta-analysis
OT  - renal cell carcinoma
OT  - sorafenib
OT  - sunitinib
OT  - targeted therapy
EDAT- 2019/07/12 06:00
MHDA- 2019/07/12 06:01
PMCR- 2019/01/01
CRDT- 2019/07/12 06:00
PHST- 2019/03/22 00:00 [received]
PHST- 2019/05/20 00:00 [accepted]
PHST- 2019/07/12 06:00 [entrez]
PHST- 2019/07/12 06:00 [pubmed]
PHST- 2019/07/12 06:01 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2019.00479 [doi]
PST - epublish
SO  - Front Oncol. 2019 Jun 21;9:479. doi: 10.3389/fonc.2019.00479. eCollection 2019.