Real‐world comparison of cabozantinib and sunitinib in advanced non‐clear cell renal cell carcinoma: A multicenter study by the Turkish Oncology Group

Non-clear cell renal cell carcinoma (nccRCC) comprises a heterogeneous group of malignancies with limited prospective data and no established first-line standard. We conducted a multicenter retrospective study across 29 centers in Turkey, including patients with advanced or metastatic nccRCC treated with first-line cabozantinib or sunitinib between 2015 and 2025. Among 268 patients (sunitinib, n = 198; cabozantinib, n = 70), baseline characteristics were balanced. Cabozantinib was associated with significantly longer median progression-free survival (PFS) compared to sunitinib (9.2 vs. 6.6 months; HR: 0.66; p = .027), while overall survival (OS) was similar (18.6 vs. 17.2 months; p = .566). Objective response rate (ORR) was higher with cabozantinib (38.6% vs. 26.3%; p = .052). Multivariate analyses identified ECOG performance status ≥2, IMDC risk category, sarcomatoid differentiation, and chromophobe histology as independent prognostic factors for OS. Predictors of PFS included IMDC risk, sarcomatoid features, nephrectomy status, and histologic subtype. These findings suggest that cabozantinib may offer improved disease control over sunitinib in this diverse patient population and provide valuable real-world insights for therapeutic decision-making in the absence of prospective randomized data.

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Journal
International Journal of Cancer
Published
2025-09-19
DOI
https://doi.org/10.1002/ijc.70165
Primary Topic
Renal cell carcinoma treatment
Type
article
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article

Real‐world comparison of cabozantinib and sunitinib in advanced non‐clear cell renal cell carcinoma: A multicenter study by the Turkish Oncology Group

Ahmet Bılıcı, Süleyman Alkan, Sung Hoon Sim, Mesut Yılmaz et al.
International Journal of Cancer
Renal cell carcinoma treatment
article

Real‐world comparison of cabozantinib and sunitinib in advanced non‐clear cell renal cell carcinoma: A multicenter study by the Turkish Oncology Group

Ahmet Bılıcı, Süleyman Alkan, Sung Hoon Sim, Mesut Yılmaz, Gamze Gököz Doğu, Hakan Yücel, Özkan Alan, S. Atas Ipek, Hüseyin Salih Semiz, Burcu Ulaş Kahya, Haydar Çağatay Yüksel, Melike Yazıcı, Elif Sertesen, İlhan Hacıbekiroğlu, Mevlüde İnanç, Faruk Recep Özalp, Murad Guliyev, Ahmet Burak Ağaoğlu, Emrah Usta, Derya Kıvrak Salim, Teyfik Demi̇r, Havva Yeşil Çınkır, Mustafa Erman, Burçak Karaca, Hasan Çağrı Yıldırım, Erdem Göker, Ertuğrul Bayram, Atila Yıldırım, Caner Acar, Ferhat Ekinci, Zeynep Gülsüm Güç, Mahmut Büyükşimşek, Erhan Gökmen, Cengiz Karaçin, Harun Muğlu, Melek Karakurt Eryılmaz, Kazım Uygun, Halil Göksel Güzel, Elif Şahin, Ozan Yazıcı, İsmail Oğuz Kara, Sait Kitaplı, Salih Tünbekici, Erkam Kocaaslan, Galip Can Uyar, Ahmet Kürşad Dişli, Mehmet Gürdal Savsar, Oğuzhan Yıldız, Banu Öztürk, Emir Gökhan Kahraman, Gamze Serin Özel, Özgür Tanrıverdi, Sema Sezgin Göksu, Olçun Ümit Ünal, Gökhan Şahin, Esra Aşık, Mehmet Cihan İcli̇, Tuğçe Kübra Güneş, Vehbi Erçolak, Esmanur Kaplan Tüzün, Pınar Ezgi Dama
article en

Abstract

Non-clear cell renal cell carcinoma (nccRCC) comprises a heterogeneous group of malignancies with limited prospective data and no established first-line standard. We conducted a multicenter retrospective study across 29 centers in Turkey, including patients with advanced or metastatic nccRCC treated with first-line cabozantinib or sunitinib between 2015 and 2025. Among 268 patients (sunitinib, n = 198; cabozantinib, n = 70), baseline characteristics were balanced. Cabozantinib was associated with significantly longer median progression-free survival (PFS) compared to sunitinib (9.2 vs. 6.6 months; HR: 0.66; p = .027), while overall survival (OS) was similar (18.6 vs. 17.2 months; p = .566). Objective response rate (ORR) was higher with cabozantinib (38.6% vs. 26.3%; p = .052). Multivariate analyses identified ECOG performance status ≥2, IMDC risk category, sarcomatoid differentiation, and chromophobe histology as independent prognostic factors for OS. Predictors of PFS included IMDC risk, sarcomatoid features, nephrectomy status, and histologic subtype. These findings suggest that cabozantinib may offer improved disease control over sunitinib in this diverse patient population and provide valuable real-world insights for therapeutic decision-making in the absence of prospective randomized data.

International Journal of CancerVol. 158(4)
Sakarya University (TR), Izmir University (TR), Karadeniz Technical University (TR), Manisa Celal Bayar University (TR), Dokuz Eylül University (TR), Akdeniz University (TR), Niğde Ömer Halisdemir Üniversitesi (TR), Ondokuz Mayıs University (TR), Izmir Kâtip Çelebi University (TR), Istanbul Medipol University (TR), Ege University (TR), Gülhane Askerî Tıp Akademisi (TR), Memorial Ankara Hospital (TR), Necmettin Erbakan University (TR), Ankara Onkoloji Eğitim ve Araştırma Hastanesi (TR), Antalya Eğitim ve Araştırma Hastanesi (TR), Ümraniye Eğitim ve Araştırma Hastanesi (TR), Istanbul University-Cerrahpaşa (TR), Sağlık Bilimleri Üniversitesi (TR), Pamukkale University (TR), Mersin Üniversitesi (TR), Kocaeli Üniversitesi (TR), Cukurova University (TR), Gaziantep University (TR), Hacettepe University (TR), Marmara University (TR), Muğla University (TR), Erciyes University (TR), Gazi University (TR)
Openalex Percentile: Top 63%
Renal cell carcinoma treatment
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