<![CDATA[Background: Pazopanib is approved as a first-line targeted therapy for metastatic renal cell carcinoma (mRCC), typically initiated at 800 mg once daily. However, maintaining this standard dose is often challenging due to patients’ poor general condition and treatment-related adverse effects. Few studies have explored whether a reduced dose could provide comparable clinical benefits with improved tolerability. This study aims to investigate the clinical survival outcomes of an initial low dose (400 mg) of Pazopanib in mRCC patients.Methods: This retrospective pilot study evaluated mRCC patients between 2019 and 2024 who were treated with an initial 400 mg Pazopanib and followed by escalation to 800 mg (if possible) at a national cancer referral hospital. If patients could not tolerate escalation dose, they received the low dose throughout treatment. Demographic data, adverse effects, and survival outcomes were collected. Radiographic progression-free survival (rPFS) and overall survival (OS) were estimated using the Kaplan-Meier method.Results: Forty-three patients (aged 21—77 years) were included, with 67.9% being male. Most patients (48.8%) had a single site of metastasis, with the liver being the most common. After a mean follow-up of 15.1 (± 7.1) months, 18 patients (41.9%) had died. The median rPFS was 14.6 months (11.6—17.6), and the median OS was 23.5 months (19.3—27.7). Only 3 patients (6.97%) discontinued treatment due to adverse effects. While 27.9% experienced no adverse events, the most common symptoms were nausea and vomiting (25.6%).Conclusions: Initiating treatment with 400 mg Pazopanib in mRCC patients may offer acceptable survival outcomes with good tolerability and compliance. In the future, this low-dose strategy could serve as a feasible alternative for patients at risk of poor tolerance to standard dosing.]]>
