Abstract: Objective To evaluate the efficacy and safety of sunitinib versus sorafenib in the firstline treatment of advanced renal cell carcinoma. MethodsFortytwo patients with advanced renal cell carcinoma were divided into two groups according to the therapeutic method. Twenty patients were treated with sunitinib (50 mg, oral administration, once a day, for 4 weeks, drug withdrawal of 2 weeks, 6 weeks was a cycle) and 22 patients were treated with sorafenib (400 mg, oral administration, twice a day, until the disease progression, 6 weeks was a cycle). The efficacy and toxicity were evaluated every 2cycle treatment. ResultsAll 42 patients could be evaluated. The disease remission rate (RR), disease control rate (DCR) of sunitinib group and sorafenib group were 30.0% (6/20), 22.7% (5/22), 90.0% (18/20), 77.3% (17/22) respectively, the median progression free survival (PFS) were 10.8, 6.2 months, the median overall survival (OS) were 25.6, 18.6 months respectively. There were no statistical differences in the RR (χ2=0.287, P=0.592) and DCR (χ2=1.222, P=0.269) between the two groups. There were statistical difference in the PFS (χ2=6.041, P=0.014) and OS (χ2=11.245, P=0.001) between the two groups. The most common toxicities of the sunitinib group were diarrhea, fatigue, oral mucositis, nausea, vomiting, all these toxicities were mainly Ⅰ-Ⅱ degree, and could be well tolerated. The handfoot syndrome rate of the sorafenib group obviously exceeded the sunitinib group (59.1% vs. 25.0%, χ2=4.972, P=0.026). ConclusionSunitinib has good efficacy in the firstline treatment of advanced renal cell carcinoma with less toxicity than sorafenib, so it is worthy of popularization.

Key words: Kidney neoplasms, Sunitinib, Sorafenib, Molecular targeted drugs