Therapeutic Drug Monitoring of Sunitinib and Pazopanib in Advanced or Metastatic Renal Cell Carcinoma

1. Is the biology right?

• Somatic driver evidence: no · None of CSF1R, KIT, LCK, FLT3 has somatic-mutation evidence in hereditary leiomyomatosis and renal cell cancer

  Rule: Open Targets has somatic-mutation evidence for the target in this cancer. Source: Open Targets: CSF1R in hereditary leiomyomatosis and renal cell cancer, 2026-11-11
• Human genetic evidence: no · No germline or somatic evidence for CSF1R, KIT, LCK, FLT3 in hereditary leiomyomatosis and renal cell cancer

  Rule: Any germline or somatic human genetic evidence for the target in this cancer, counted apart from animal-model and literature evidence. Source: Open Targets: CSF1R in hereditary leiomyomatosis and renal cell cancer, 2026-11-11
• Pediatric target: yes · CSF1R, KIT, FLT3 on the FDA list

  Rule: Target is on FDA's Pediatric Molecular Target List (relevant targets); membership alone neither requires nor waives a study. Source: FDA Pediatric Molecular Target List (Listed as February 2026 on the FDA Pediatric Oncology page; the file served is 9.7.22_the_relevant_molecular_target_list.xlsx, whose Summary of Changes sheet is headed 'SEPTEMBER 2022 UPDATE' (footnote date 2022-09-01)), 2026-11-11
• Haematologic cancer: no · Solid tumour

  Rule: From the indication, or the registry conditions when no indication matches. Source: ClinicalTrials.gov NCT02555748, 2026-11-11

  Published context: Likelihood of approval from phase 1: 7.5% haematologic vs 4.6% solid (BIO / Informa / QLS 2021, 2011–2020). Population-level, not a prediction.

• CSF1R (via Pazopanib): Open Targets has no association between CSF1R and hereditary leiomyomatosis and renal cell cancer. · Open Targets: CSF1R in hereditary leiomyomatosis and renal cell cancer
• KIT (via Pazopanib): Evidence types in hereditary leiomyomatosis and renal cell cancer: literature, animal_model; literature and animal_model listed separately from human genetics. Datasources: impc, europepmc. · Open Targets: KIT in hereditary leiomyomatosis and renal cell cancer
• LCK (via Pazopanib): Open Targets has no association between LCK and hereditary leiomyomatosis and renal cell cancer. · Open Targets: LCK in hereditary leiomyomatosis and renal cell cancer
• FLT3 (via Sunitinib): Open Targets has no association between FLT3 and hereditary leiomyomatosis and renal cell cancer. · Open Targets: FLT3 in hereditary leiomyomatosis and renal cell cancer

• Not loaded on this app yet: Normal-tissue expression in vital organs. Source: Human Protein Atlas (ticket 36).
• Not loaded on this app yet: Pan-essential in cell lines. Source: DepMap (ticket 36).
• Not loaded on this app yet: Approved drug on this target. Source: Drugs@FDA (ticket 30).

2. Can the result be trusted?

• Randomised: no · Non-randomised

  Rule: Registry allocation field. Source: ClinicalTrials.gov NCT02555748, 2026-11-11
• Small denominator: no · 47 enrolled; each patient moves a rate by 100 ÷ 47 = 2.1 points

  Rule: Enrolment under 30; the arithmetic is shown, not a benchmark. Source: ClinicalTrials.gov NCT02555748, 2026-11-11
• Primary endpoint is overall survival: no · Part I: Pharmacokinetics - Pazopanib or Sunitinib plasma concentrations; Part II: Tolerance - Proportion of patients without treatment discontinuation due to adverse event (AE) during the fi…; Part II: Efficacy - Proportion of patients without progression at 1 year. This corresponds to the number of patients … (and 1 more)

  Rule: A registered primary outcome measure names overall survival. Source: ClinicalTrials.gov NCT02555748, 2026-11-11

  Published context: Non-OS primary endpoint: odds ratio 2.79 for a positive phase 3 (Otsuka 2021, 400 phase 3 oncology trials, to 2020). Shown with the next figure: a surrogate is easier to hit, and often a weak guide to survival.

  Published context: 52% of surrogate-to-OS correlations are low (Prasad 2015, published to 2014). Shown with the figure above.
• Results overdue: yes · Primary completion 2020-01-16, 81 months ago; no results posted

  Rule: Primary completion (actual) more than 12 months ago and no results posted to the registry. Source: ClinicalTrials.gov NCT02555748, 2026-11-11

  Published context: 40.9% of applicable trials report results within a year (Results-reporting studies summarised in spec §11, all therapy areas). All areas, not oncology only.

• Not loaded on this app yet: Treated and evaluable counts, assessor, confirmed response, follow-up and data cutoff. Source: Readout extraction (ticket 32).
• Not loaded on this app yet: Primary endpoint changed between registry versions. Source: Registry versions in the store (ticket 32).

3. What must it beat?

• Not loaded on this app yet: Control-arm result and approved therapies for the same segment, with label links. Source: Drugs@FDA, FDA labels and readouts (tickets 30, 32).

4. Too crowded, or too late?

• Stopped on this target: 200 terminated, withdrawn or suspended trials of drugs against CSF1R; 28 give no reason. Reasons are quoted as the registry gives them on the target page. · CSF1R: what already stopped

• Not loaded on this app yet: Programs on the target by phase and months behind the leader. Source: Programs and Drugs@FDA (ticket 33).

5. Can it be approved, and stay approved?

• Single-country: yes · All 8 sites in France

  Rule: All listed sites are in one country; the share of US sites is shown. Source: ClinicalTrials.gov NCT02555748, 2026-11-11
• EU paediatric investigation plan: yes · EMEA-000601-PIP01-09-M06 (pazopanib, Treatment of Ewing sarcoma family of tumours;Treatment of non-rhabdomyosarcoma soft tissue sarcoma;Treatment of rhabdomyosarcoma): PM: decision on the application for modification of an agreed PIP, 11 Sept 2019; compliance positive 24 Jul 2020; EMEA-000342-PIP01-08-M07 (sunitinib, Treatment of gastro-intestinal stromal tumours): PM: decision on the application for modification of an agreed PIP, 7 May 2018; compliance positive 29 Jun 2018

  Rule: An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name. Source: EMA data download (dated snapshot), 2026-11-11
• EU orphan designation: yes · EU/3/06/382 withdrawn 29 Jun 2006: Treatment of renal-cell carcinoma

  Rule: An EU orphan designation lists the drug as its active substance (exact name) or belongs to a medicine that does; withdrawn and expired designations are listed with their status. Source: EMA EU/3/06/382, 2026-11-11
• Authorised in the EU: yes · Sunitinib Accord: authorised since 11 Feb 2021; Votrient: authorised since 14 Jun 2010; Sutent: authorised since 19 Jul 2006

  Rule: An EMA medicine record lists the drug as its active substance or INN, exact name; national-only authorisations are not in this file. Source: EMA data download (dated snapshot), 2026-11-11
• FDA orphan designation: not published · FDA's orphan designation database turns away automated requests, so this app does not read it; search it by hand at the link

  Rule: Would be: an FDA orphan designation names the drug. Source: FDA orphan designations search
• FDA pediatric oncology approval: no · FDA's table lists no pediatric approval of Pazopanib, Sunitinib

  Rule: FDA's Pediatric Oncology Drug Approvals table names the drug. Source: FDA Pediatric Oncology Drug Approvals (content current as of 2026-03-03), 2026-11-11
• Registered studies open to children: yes · 46 interventional studies of Pazopanib, Sunitinib include patients under 18; 11 are recruiting, not yet recruiting or active

  Rule: The registry's age group includes Child (birth to 17 years), which also counts studies that set no minimum age. Source: ClinicalTrials.gov search, 2026-11-11

• Caveat: Site counts are not patients per country, and trials registered only outside ClinicalTrials.gov are not covered. Where the sites are is a fact about the record, not a judgement of its quality.
• Cited case: In February 2022 FDA asked its Oncologic Drugs Advisory Committee whether sintilimab's application, resting on ORIENT-11, a phase 3 run only in China, needed further trials showing it applies to US patients and US practice. One case, not a rule. · FDA, ODAC 10 Feb 2022, draft questions
• Rare pediatric disease voucher: FDA, content current as of 29 Apr 2026: “As of February 3, 2026, enactment of the Consolidated Appropriations Act, 2026, the rare pediatric disease PRV program will sunset after September 30, 2029. FDA may not award any PRVs under this program after September 30, 2029.” Voucher sale prices are not shown here; they appear only as company-reported news. · FDA: Rare Pediatric Disease Designation and Priority Review Voucher Programs

• Not loaded on this app yet: Precedent approvals for target, modality and endpoint; accelerated-approval status. Source: Drugs@FDA and FDA accelerated-approval tables (ticket 30).

6. Can the sponsor finish?

• Sponsor: Institut Claudius Regaud (academic or other) · ClinicalTrials.gov NCT02555748
• principal investigator: Christine CHEVREAU, MD, IUCT-O · Person page

• Not loaded on this app yet: Filed cash, quarterly spend and the runway arithmetic. Source: SEC XBRL company facts (ticket 37).
• Not loaded on this app yet: Sponsor's completed vs stopped oncology trials and results-reporting record. Source: Registry, by company (ticket 37).

What public data cannot tell you

Public records cannot show: sales forecasts; a probability of success for this asset; full deal terms and net prices; FDA designations and action dates before approval (shown only as company-reported); clinical holds unless the company disclosed them; manufacturing; patents on unapproved drugs; whether preclinical findings have been replicated.