Commentary on Sequential therapy with sorafenib and sunitinib in renal cell carcinoma: Dudek AZ, Zolnierek J, Dham A, Lindgren BR, Szczylik C, Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapol

Sunitinib and sorafenib are small-molecule tyrosine kinase inhibitors (TKI) with antitumor activity in advanced renal cell carcinoma. A retrospective study was conducted to assess the response of renal cell carcinoma to sequential treatment with these 2 agents. response was evaluated by using Response Evaluation Criteria in Solid Tumors (RECIST) in patients failing first-line therapy with either sunitinib or sorafenib and subsequently receiving second-line therapy with the other TKI agent. -nine patients received sorafenib followed by sunitinib (group A), and 20 patients received sunitinib followed by sorafenib (group B). TKI drugs were terminated in 6 (12%) patients in group A and 4 (8%) in group B because of toxicity. Median duration of stable disease for groups A and B was 20 and 9.5 weeks, respectively. Median time from starting first TKI to disease progression after second TKI (time to progression) in groups A and B was 78 and 37 weeks, respectively. Multivariate analysis revealed that group B had a shorter time to progression than group A (risk ratio [RR] 3.0; P = 0.016). Median overall survival was 102 and 45 weeks in groups A and B, respectively (P = 0.061). nger duration of disease control in patients who received sorafenib followed by sunitinib warrants further investigation.