Efficacy and safety analysis of TACE + sunitinib vs. sunitinib in the treatment of unresectable advanced renal cell carcinoma: a retrospective study

Background: Since renal cell carcinoma (RCC) is insensitive to conventional chemoradiotherapy, molecularly targeted drugs are commonly used for unresectable advanced RCC. The aim of this study was to explore the efficacy and safety of TACE plus sunitinib versus sunitinib alone in unresectable advanced RCC. Methods: A retrospective study included 98 patients with unresectable advanced RCC treated at Union Hospital from January 2015 to December 2018. Patients were divided into TACE + sunitinib (N = 47) and sunitinib (N = 51) groups. Efficacy and safety were analyzed. Results: In the TACE + sunitinib group, 4 (8.5%) achieved CR, 27 (57.5%) PR, 9 (19.1%) SD, and 7 (14.9%) PD; in the sunitinib group, 0 CR, 20 (39.2%) PR, 14 (27.5%) SD, and 17 (33.3%) PD (P = 0.017). ORR was 66.0% vs. 39.2% (P = 0.009) and DCR was 85.1% vs. 66.7% (P = 0.038) for TACE + sunitinib vs. sunitinib, respectively. Median PFS was 15.6 vs. 10.9 months and median OS was 35.0 vs. 25.7 months (both P < 0.001). Abdominal pain, fever, and vomiting occurred more often with TACE + sunitinib (55.3% vs. 13.7%; 61.7% vs. 7.8%; 40.4% vs. 19.6%; all P < 0.05). TACE technical success was 100%. Conclusions: TACE combined with sunitinib achieved higher ORR and DCR and longer OS and PFS than sunitinib alone, with manageable safety, and may serve as a complementary, effective option for advanced unresectable RCC.