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Sequential Use of Sutent and Nexavar
A poster was presented by Anu Dahm of the University of Minnesota of a study to evaluate the response of sequential use of Sutent and Nexavar. Patients whose disease had progressed or who had suffered unacceptable toxicities with the first line drug were then given the second drug. 37 patients entered the study and were divided into two groups. Group A had 23 patients receiving Nexavar then Sutent, while Group B had 14 receiving Sutent then Nexavar. Three people in Group A and two in Group B switched therapies due to toxicities. The others switched due to disease progression. The risk factors of both groups were similar.
Sequential Use Results
| |
Group A |
Group B |
| |
Nexavar --> Sutent |
Sutent --> Nexavar |
| |
n = 23 |
n = 14 |
|
Complete Response |
0% |
7% |
|---|---|---|
|
Partial Response |
17% |
0% |
|
Stable Disease (SD) |
40% |
36% |
|
Progressive Disease |
34% |
50% |
|
Not Evaluable |
9% |
7% |
|
Median Duration of SD |
32 weeks |
8 weeks |
The 7% Complete Response for Group B represents one patient who had a complete response after resection.
The authors of the study drew the obvious conclusion that the duration of response was longer in patients receiving Nexavar followed by Sutent. What's interesting is that there is no cross resistance of therapies, that is, there was still a response, or at least stability, after second-line treatment by either therapy. Secondly, while the two therapies have not gone head-to-head, it is clear from this and other trial data and from the kidney cancer specialists at ASCO that Sutent is the preferable first-line drug with Nexavar limited to a second-line therapy when Sutent has failed.