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Votrient (Pazopanib) Tops Sutent (Sunitinib) in Patient Preference Study

Phase III assessment compares renal cancer therapies

Data from the first patient preference study in advanced renal cell carcinoma (RCC) have been published in the Journal of Clinical Oncology. In the PISCES study, more patients expressed a preference for continuing treatment with Votrient (pazopanib, GlaxoSmithKline) than with Sutent (sunitinib, Pfizer).

The study’s objective was to investigate patient-reported treatment preference and certain health-related quality of life outcomes for patients with locally advanced and/or metastatic RCC who received no prior systemic therapy.

The results showed that 70% of patients expressed a preference for pazopanib compared with 22% expressing a preference for sunitinib, as assessed by a questionnaire. This equates to a statistically significant difference of 49% (P < 0.001). Eight percent of patients expressed no preference. The PISCES study was not designed to measure or compare the clinical efficacy of pazopanib and sunitinib.

One of the study’s secondary endpoints assessed the reasons for patient preference. The most commonly cited reasons for preferring pazopanib were “better quality of life” and “less fatigue.” In patients preferring sunitinib the most common reasons were “less diarrhea” and “better quality of life.”

The PISCES (PazopanIb Versus Sunitinib Patient PreferenCE Study in Treatment-Naïve Metastatic Renal Cell Carcinoma) trial was a randomized, double-blind, phase IIIb crossover study involving 169 patients with advanced and/or metastatic RCC. The study’s primary objective was to assess how the tolerability and safety differences between pazopanib and sunitinib translate into patient preference, as determined by the patient’s stated preference for which drug they chose to continue taking at the end of the study. Supplementary information was collected on the reasons for patient preference, on fatigue and health-related quality of life, on dose modifications and time to dose modification, and on safety and tolerability.

The most common adverse events (AEs) for pazopanib compared with sunitinib, respectively, included diarrhea (42% vs. 32%), nausea (33% vs. 30%), decreased appetite (20% vs. 19%), vomiting (14% vs. 16%), dyspepsia (10% vs. 16%), dysgeusia (16% vs. 27%), mucositis (16% vs. 22%), hand-foot syndrome (16% vs. 26%), hair color changes (17% vs. 14%), hypertension (23% vs. 26%), asthenia (16% vs. 24%), fatigue (29% vs. 30%), headache (14% vs. 11%), and abdominal pain (13% vs. 11%).

Two fatal serious AEs (SAEs) were reported in the pazopanib group (respiratory failure and peritonitis), and two fatal SAEs were reported in the sunitinib group (dyspnea and worsening of general condition). None of these fatal SAEs was considered treatment related. In addition, three patient deaths occurred because of progressive disease (one pazopanib-treated patient and two sunitinib-treated patients).

Sources: GSK; April 2, 2014; and JCO; March 31, 2014.

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