Sunitinib and Sorafenib trial in locally advanced renal cell carcinoma

Currently the targeted therapy drugs Sunitinib and Sorafenib are widely used in the UK for use in metastatic renal cell cancer and help patients live longer with their disease. Sunitinib and Sorafenib are tyrosine kinase inhibitors which act to block signals within the cancer cell which would otherwise cause the cell to grow and divide, thereby causing the cancer cell to die. They also stop the cancer cells from forming new blood vessels. Without tumour-supporting blood vessels, the cancer cells die due to a lack of oxygen and nutrients.
Sunitinib and Sorafenib are currently under investigation for use in locally advanced (non-metastatic) renal cell cancer in a number of studies. It is hoped that these drugs may benefit patients with less advanced disease as well as patients with metastatic kidney cancer, for which they are currently licenced. One of these studies in the US has recently published results suggesting that neither Sunitinib nor Sorafenib are any more effective than standard care in reducing the recurrence rate of the disease.
The phase III trial involved 1943 patients from the US and Canada. The drugs were taken for a year after surgical kidney resection to remove the tumour. They found that there was no significant difference in disease free survival between patients given Sunitinib, Sorafenib or placebo (standard care).
Although the outcome of the trial is disappointing, there is hope that using other tyrosine kinase inhibitors or a different length of therapy could have a more favourable outcome. During the trial a very large collection of tumour tissue, blood and urine with associated treatment and outcome data was accumulated. Further analysis of this data might suggest that tyrosine kinase inhibitors could benefit certain patients and not others, may provide clues as to why disease recurs, and why some tumours are resistant to this therapy. The outcome of this trial may help avoid unnecessary toxicity. We will also have to wait to see if future investigations confirm the findings of this trial.
 
For more information about the study please see the following Medical Xpress article: Sunitinib, sorafenib of no benefit in ECOG-ACRIN renal cell trial