Table 1.
Agent | MOA | FDA approval | Pivotal trial comparator | Pivotal trial population | Primary endpoint | Outcome | References |
---|---|---|---|---|---|---|---|
Tivozanib | VEGF TKI | Pending | Sorafenib | Treatment naïve; one prior non-VEGF/non-mTORi allowed | PFS | PFS 11.9 months (tivozanib) vs 9.1 months (sorafenib), P = 0.042; treatment naïve subset: 12.7 months vs 9.1 months, P = 0.037 | 24 |
Sorafenib | VEGF TKI | Approved | Placebo | Prior cytokine allowed | PFS | PFS 5.5 months (sorafenib) vs 2.2 months (placebo), P < 0.000001 | 17,18 |
Sunitinib | VEGF TKI | Approved | IFN | Treatment naïve | PFS | PFS 11 months (sunitinib) vs 5 months (IFN), P = 0.001 | 13,14 |
Temsirolimus | mTORi | Approved | IFN Temsirolimus/IFN | Treatment naïve | OS | OS 10.9 months (temsirolimus) vs 7.3 months (IFN), P < 0.001 | 19 |
Everolimus | mTORi | Approved | Placebo | One or two prior VEGF TKI | PFS | PFS 4.9 months (everolimus) vs 1.9 months (placebo), P = 0.001 | 20,21 |
Bevacizumab/IFN | Monoclonal VEGF Ab | Approved | IFN | Treatment naïve | PFS | AVOREN trial: PFS 10.2 months (bevacizumab/IFN) vs 5.4 months (IFN), P < 0.0001 | 9–12 |
CALGB trial: PFS 8.5 months (bevacizumab/IFN) vs 5.2 months (IFN), P = 0.0001 | |||||||
Pazopanib | VEGF TKI | Approved | Placebo | Treatment naïve or prior cytokine allowed | PFS | PFS 9.2 months (pazopanib) vs 4.2 months (placebo), P < 0.0001 | 15 |
Axitinib | VEGF TKI | Approved | Sorafenib | One prior therapy (sunitinib, bevacizumab, cytokine, or temsirolimus) allowed | PFS | PFS 6.7 months (axitinib) vs 4.7 months (sorafenib), P < 0.0001 | 16 |
Abbreviations: Ab, antibody; IFN, interferon; mTORi, mammalian target of rapamycin inhibitor; OS, overall survival; PFS, progression-free survival; RCC, renal cell carcinoma; VEGF TKI, vascular endothelial growth factor tyrosine kinase inhibitor; MOA, mechanism of action; FDA, Federal Drug Administration.