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RTK Inhibitor Plus Immunotherapy in Advanced Kidney Cancer

By: Cordi Craig
Posted: Wednesday, March 18, 2020

Pavlos Msaouel, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues suggested that nivolumab plus the RTK inhibitor sitravatinib may be a more effective treatment option for patients with advanced clear cell renal cell carcinoma than single-agent nivolumab or single-agent cabozantinib. In the phase I/II trial, patients treated with the dual therapy appeared to achieve higher response rates and longer disease control than those patients treated with nivolumab alone. The early-phase study findings were presented at the 2020 Genitourinary (GU) Cancers Symposium in San Francisco (Abstract 612).

The research team evaluated the safety and efficacy of nivolumab plus sitravatinib in 40 patients with advanced clear cell renal cell carcinoma whose disease progressed on up to two prior VEGF-targeted therapies. All study patients were evaluable for safety, and 38 patients were evaluable for efficacy. The median follow-up was 17.7 months.

Clinical benefits were reported in 35 patients (92%). The objective response rate was 39%, with responses observed in 15 patients. The median progression-free survival was 10.3 months. After at least 6 months, 23 patients (67.6%) achieved disease control. The overall survival rate was not reached, and at the time of the presentation, 30 patients were still alive.

Treatment-related adverse events were reported in 30 patients (75%). Approximately half of the patient pool (n = 21) required dose reductions of sitravatinib within the first 12 weeks of treatment. Fatigue, diarrhea, palmar-plantar erythrodysesthesia, hypertension, and elevated amylase and lipase levels were the most common treatment-related adverse events. Myasthenia gravis was the lone grade 5 nivolumab-related toxicity. Ongoing analyses of patient-reported outcomes and tissue and blood correlative studies are being explored, the authors concluded.

Disclosure: For full disclosures of the study authors, visit coi.asco.org.



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