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Week of April 19, 2009 < Back ¦ 2009 ¦ Home

Hot Paper in Medicine

"Sunitinib versus inteferon alfa in metastatic renal-cell carcinoma," by Robert J. Motzer and 14 others, New England Journal of Medicine, 356(2): 115-24, 11 January 2007.

[Authors' affiliations: 10 institutions worldwide]

Abstract: "BACKGROUND Since sunitinib malate has shown activity in two uncontrolled studies in patients with metastatic renal-cell carcinoma, a comparison of the drug with interferon alfa in a phase 3 trial is warranted. METHODS We enrolled 750 patients with previously untreated, metastatic renal-cell carcinoma in a multicenter, randomized, phase 3 trial to receive either repeated 6-week cycles of sunitinib (at a dose of 50 mg given orally once daily for 4 weeks, followed by 2 weeks without treatment) or interferon alfa (at a dose of 9 MU given subcutaneously three times weekly). The primary end point was progression-free survival. Secondary end points included the objective response rate, overall survival, patient-reported outcomes, and safety. RESULTS The median
progression-free survival was significantly longer in the sunitinib group (11 months) than in the interferon alfa group (5 months), corresponding to a hazard ratio of 0.42 (95% confidence interval, 0.32 to 0.54; P<0.001). Sunitinib was also associated with a higher objective response rate than was interferon alfa (31% vs. 6%, P<0.001). The proportion of patients with grade 3 or 4 treatment-related fatigue was significantly higher in the group treated with interferon alfa, whereas diarrhea was more frequent in the sunitinib group (P<0.05). Patients in the sunitinib group reported a significantly better quality of life than did patients in the interferon alfa group (P<0.001). CONCLUSIONS Progression-free survival was longer and response rates were higher in patients with metastatic
renal-cell cancer who received sunitinib than in those receiving interferon alfa."

This 2007 report from the New England Journal of Medicine was cited 65 times in current journal articles indexed by Clarivate Analytics during November-December 2008. Only one other medicine paper published in the last two years, aside from reviews, collected a higher citation total during that two-month period. Although Motzer et al. has slipped slightly from its #1 ranking last time, it continues its year-plus-long run among medicine's most cited. Prior to the most recent bimonthly count, citations to the paper have accrued as follows:

September-October 2008: 65 citations
July-August 2008: 63
May-June 2008: 49
March-April 2008: 56
January-February 2008: 41
November-December 2007: 40
September-October 2007: 44
July-August 2007: 24
May-June 2007: 10
March-April 2007: 2
January-February 2007: 2

Total citations to date: 461

SOURCE: Hot Papers Database (Included with a subscription to the print newsletter Science Watch®, available from the Research Services Group of Thomson Reuters. Packaged on a CD that is mailed with each Science Watch issue, the Hot Papers Database contains data on hundreds of highly cited papers published during the last two years. User interface permits searching by author, organization, journal, field, and more. Total citations, as well as citations accrued during successive bimonthly periods, can be assessed and graphed. An updated CD containing the most recent bimonthly data is mailed with every new issue of Science Watch, six times a year. The CD also includes an electronic version of the Science Watch issue in HTML format, for personal desktop access.

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