More than selleck chemical half of all patients had 3 or more metastatic sites at the baseline. The most prevalent metastatic sites were lung and lymph nodes, 16. 5% of patients Inhibitors,Modulators,Libraries receiving sunitinib and 16. 7% of patients receiving sorafenib had brain metastases at baseline. Almost all patients had a history of nephrect omy and immunotherapy. Safety Table 2 presents the frequencies and rates of all grade and grade 3 4 adverse events observed in the study population, as reported in patients medical charts. Among patients receiving sunitinib and sorafenib, 97. 6% and 70. 0%, respectively, experienced at least one adverse event. The most common all grade adverse event for both MKIs was fatigue or asthenia, observed in 81. 2% of patients receiving sunitinib and 43. 3% of patients receiving sorafenib.

In patients receiving suni tinib, other frequently reported all Inhibitors,Modulators,Libraries grade adverse events included mucositis or stomatitis and decreased taste sensation. In patients receiving sorafenib, hand foot syndrome was the second most frequently reported all grade adverse event, followed by diarrhea. Fatigue or asthenia was also the most common grade 3 4 adverse events for both agents, reported in 9. 4% of patients receiving sunitinib and 10. 0% of patients receiving sorafenib. Other frequently reported grade 3 4 adverse events included anorexia and vomiting and hyper tension, nausea, and abdominal pain in patients treated with sunitinib, and hypertension, hand foot syndrome, diarrhea, abdominal pain, skin rash, and dyspnea in patients treated with sorafenib.

Treatment Patterns Table 3 summarizes Inhibitors,Modulators,Libraries the treatment Inhibitors,Modulators,Libraries patterns for first line MKIs and reasons for treatment modifications. The median duration of first line MKI treatment was 6. 6 months for sunitinib and 5. 8 months for sorafenib. Among patients receiving sunitinib, 77. 6% discontin ued treatment, 34. 1% had a treatment interruption, and 35. 3% had a dose reduction. In patients receiving sorafe nib, 85. 0% discontinued treatment, 26. 7% had a Table 4 shows the adverse events reported as reasons for treatment modifications. Forty percent of patients receiving sunitinib and 45% of patients receiving sorafe nib had at least one treatment modification due to adverse events. The adverse events most frequently reported as reasons for treatment discontinuation were treatment interruption, and 38. 3% had a dose reduction.

Progressive disease was the most frequently reported reason for treatment discontinuation in both groups, followed by adverse events. For both MKIs, adverse events were the most frequently reported rea sons for treatment interruptions and dose Inhibitors,Modulators,Libraries reductions. Enzastaurin solubility Table 3 also describes the reasons for changes in treatment from one MKI to another. Among patients who received sunitinib as first line MKI, 17. 6% switched to sorafenib as a second line treatment.