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TKIs After Immunotherapy Failure in Metastatic Renal Cell Carcinoma

By: Kayci Reyer
Posted: Friday, January 18, 2019

Second-line tyrosine kinase inhibitor (TKI) therapy after failure of first-line nivolumab/ipilimumab treatment was found to be beneficial in patients with metastatic renal cell carcinoma, according to international research published in the European Journal of Cancer. “Median [progression-free survival] suggests a sustained benefit of TKI and supports trials investigating the optimal sequence,” concluded Laurence Albiges, MD, PhD, of Gustave Roussy, Villejuif, France, and colleagues.

The retrospective study included the medical records of 33 patients with metastatic renal cell carcinoma who were treated with first-line nivolumab/ipilimumab and a subsequent TKI in 13 medical facilities. Best response was assessed in 30 patients, with a median follow-up from initiation of TKI treatment of 22 months.

Overall, 12 patients (36%) achieved a partial response, 13 (39%) had stable disease, and 5 (15%) experienced disease progression. From the start of second-line TKI, the median progression-free survival was 8 months. At 12-month follow-up, the overall response rate was 54%.

Differences in progression-free survival outcomes were found between patients receiving first-generation (sunitinib/pazopanib; 8 months) and second-generation TKIs (axitinib/cabozantinib; 7 months). Patients whose first-line duration of response to the double immune checkpoint blockade was at least 6 months experienced an extended period of progression-free survival when compared with patients who had a shorter first-line duration of response (8 months vs. 5 months; P= .03) A total of 42% of patients developed 1 or more toxicities of at least grade 3, which was in line with the expectations of the investigators.

Disclosure: The study authors’ disclosure information may be found at ejcancer.com.



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