A 55-year-old woman in excellent overall health was diagnosed with a13 cm left renal mass extending into the left renal vein and concomitant low volume pulmonary metastases. She underwent an uneventful cytoreductive left radical nephrectomy.
Pathology reveals Fuhrman Grade 3 clear cell renal cell carcinoma. Repeat imaging demonstrates rapid disease progression with worsening thoracic metastatic disease and new asymptomatic bony metastases.
The doctor and the patient reach a joint decision to proceed with targeted therapy.
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The COMPARZ trial recently confirmed far superior side effect profile of pazopanib compared with sunitinib.
Furthermore, pazopanib failed to show inferiority in efficacy. Results from an earlier PISCES trial, presented at ASCO 2012, demonstrated that patients who were blinded to which drug they were taking were much more likely to prefer pazopanib.
Due to more selective inhibition of c-kit, pazopanib is much more likely to result in hair depigmentation.
Answer: Pazopanib exhibits inferior efficacy than sunitinib
This case was prepared by Alexander Kutikov, MD, of Fox Chase Cancer Center in Philadelphia.