Lenvatinib is More Effective & Safer Than Sorafenib in the Treatment of Renal Cell Carcinoma - A Single-Center Retrospective Analysis of 70 Cases
DOI:
https://doi.org/10.64149/J.Carcinog.23.1.624-628Keywords:
Renal Cell Carcinoma (RCC), Lenvatinib, Sorafenib, Tyrosine Kinase Inhibitor (TKI), Progression-Free Survival (PFS), Disease Control Rate (DCR), Targeted Therapy, Adverse Events/Safety Profile.Abstract
Background: Lenvatinib and sorafenib are multi-tyrosine kinase inhibitors used in advanced renal cell carcinoma (RCC). Comparative real-world data remain limited. We performed a retrospective single-center analysis of 70 patients to compare efficacy and safety of lenvatinib versus sorafenib in routine practice. Methods: Seventy consecutive patients with advanced or metastatic RCC treated between January 2021 to December 2023 were reviewed. Patients received either lenvatinib (n = 35) or sorafenib (n = 35) as systemic therapy (first- or subsequent-line as per treating physician). Primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), objective response rate (ORR; RECIST v1.1), disease control rate (DCR), and grade ≥3 adverse events (CTCAE v5.0). Kaplan–Meier estimates, log-rank tests, Cox proportional hazards models, and chi-square/Fisher exact tests were used. A two-sided p < 0.05 was considered significant. Results: Median follow-up 18.2 months (IQR 11.0–29.4). Median PFS was 10.8 months (95% CI 8.1–13.6) with lenvatinib vs 6.4 months (95% CI 4.7–8.1) with sorafenib (HR 0.58; 95% CI 0.36–0.93; p = 0.023). Median OS was 22.5 months (95% CI 16.4–28.6) vs 16.1 months (95% CI 11.5–20.7) favoring lenvatinib (HR 0.69; 95% CI 0.41–1.16; p = 0.160). ORR was 34.3% vs 11.4% (p = 0.018); DCR 77.1% vs 54.3% (p = 0.028). Grade ≥3 adverse events occurred in 22.9% (lenvatinib) vs 37.1% (sorafenib) (p = 0.18). Lenvatinib had higher rates of hypertension and proteinuria but fewer hand–foot skin reaction and fatigue ≥ grade 3. Dose reductions were required in 28.6% (lenvatinib) vs 40.0% (sorafenib). Conclusions: In this retrospective series of 70 patients, lenvatinib was associated with significantly longer PFS and higher response rate than sorafenib and a numerically lower rate of high-grade toxicities. Prospective randomized data are required to confirm these findings in routine practice.
