# ASPEN: everolimus versus sunitinib in metastatic non-clear cell renal cell carcinoma

Source: https://onco.cc/key-papers/paper-aspen-armstrong-lancet-oncol-2016/  
OnCo record `paper-aspen-armstrong-lancet-oncol-2016` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In the first randomised trial dedicated to non-clear cell kidney cancers, sunitinib delayed progression more than everolimus overall, though chromophobe tumours appeared to fare better on everolimus.

## Summary

Randomised phase 2 trial of 108 patients with metastatic papillary, chromophobe or unclassified renal cell carcinoma randomised to sunitinib or everolimus.

Median progression-free survival was 8.3 months with sunitinib against 5.6 months with everolimus (hazard ratio 1.41 for everolimus); in the small chromophobe subgroup everolimus gave longer progression-free survival (11.4 versus 5.5 months), while papillary tumours did better with sunitinib.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet Oncology
- Year: 2016
- DOI: 10.1016/S1470-2045(15)00515-X
- Authors: Armstrong AJ, Halabi S, Eisen T, et al.
- Findings: Median progression-free survival 8.3 months (sunitinib) vs 5.6 months (everolimus).; Chromophobe subgroup: 11.4 months with everolimus vs 5.5 months with sunitinib.
- What it means: VEGF-directed therapy is the default for non-clear cell disease, with everolimus considered in chromophobe tumours; cabozantinib later became preferred for papillary disease.
- Caveats: Small heterogeneous trial; subgroup findings are hypothesis-generating.

## Sources

- Lancet Oncol 2016: https://doi.org/10.1016/S1470-2045(15)00515-X
- PubMed: https://pubmed.ncbi.nlm.nih.gov/26794930/

## Connected records

- cancers: [Chromophobe renal cell carcinoma](https://onco.cc/cancers/chromophobe-rcc/), [Papillary renal cell carcinoma](https://onco.cc/cancers/papillary-rcc/)
- drugs: [Everolimus](https://onco.cc/drugs/everolimus/), [Sunitinib](https://onco.cc/drugs/sunitinib/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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