# PAPMET (SWOG 1500): cabozantinib versus sunitinib for metastatic papillary renal cell carcinoma

Source: https://onco.cc/key-papers/paper-papmet-pal-lancet-2021/  
OnCo record `paper-papmet-pal-lancet-2021` (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 to show a benefit in papillary kidney cancer, the MET-targeting kinase inhibitor cabozantinib delayed progression and tripled the response rate compared with sunitinib, while two other MET inhibitors did not.

## Summary

Randomised phase 2 trial of 147 patients with metastatic papillary renal cell carcinoma randomised to sunitinib, cabozantinib, crizotinib or savolitinib; the crizotinib and savolitinib arms closed early for futility.

Median progression-free survival was 9.0 months with cabozantinib against 5.6 months with sunitinib (hazard ratio 0.60) and response 23 versus 4 percent.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2021
- DOI: 10.1016/S0140-6736(21)00152-5
- Authors: Pal SK, Tangen C, Thompson IM, et al.
- Findings: Median progression-free survival 9.0 vs 5.6 months; hazard ratio 0.60.; Objective response 23 percent vs 4 percent.
- What it means: Cabozantinib is the preferred first-line targeted therapy for metastatic papillary renal cell carcinoma; immunotherapy combinations are being tested on top of it.
- Caveats: Small phase 2 with unselected MET status.; Savolitinib may still have a role in MET-driven tumours.

## Sources

- Lancet 2021: https://doi.org/10.1016/S0140-6736(21)00152-5
- PubMed: https://pubmed.ncbi.nlm.nih.gov/33592176/

## Connected records

- cancers: [Papillary renal cell carcinoma](https://onco.cc/cancers/papillary-rcc/)
- drugs: [Cabozantinib](https://onco.cc/drugs/cabozantinib/), [Crizotinib](https://onco.cc/drugs/crizotinib/), [Savolitinib](https://onco.cc/drugs/savolitinib/), [Sunitinib](https://onco.cc/drugs/sunitinib/)
- trials: [PAPMET (SWOG S1500)](https://onco.cc/trials/papmet/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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