Abstract | BACKGROUND: METHODS: A retrospective analysis was performed on patients with metastatic ccRCC treated at the Memorial Sloan Kettering Cancer Center and Cleveland Clinic who initiated systemic therapy post IO- VEGF including combinations with VEGF receptor (VEGFR) tyrosine kinase inhibitors (IO-TKI) and combinations with the anti- VEGF monoclonal antibody bevacizumab (IO-Bev). The study objectives were to evaluate the objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) on systemic therapy post IO- VEGF. RECIST v1.1 criteria were used to determine radiological responses and progression. Survival estimates were evaluated with the Kaplan-Meier methods and the log-rank test from the start of systemic therapy post IO- VEGF to the event of interest. RESULTS: A total of fifty-nine patients were treated post discontinuation of IO- VEGF regimens which included IO-Bev (n = 35; 59%) and IO-TKI (n = 24; 41%). Fifty-eight patients (98%) received IO- VEGF regimens as part of a clinical trial. Subsequent therapies included cabozantinib (n = 22; 37%), axitinib (n = 18; 31%), pazopanib (n = 4; 7%), lenvatinib and everolimus (n = 4; 7%), mTOR inhibitor monotherapy (n = 3; 5%), axitinib and dalantercept (n = 2; 3%), sunitinib (n = 1; 2%), sorafenib (n = 1; 2%), and treatment with agents on unreported clinical trials (n = 4; 7%). Patients treated on unreported clinical trials were excluded from the efficacy analysis. Post IO- VEGF, the ORR was 25% and median PFS was 12.0 months (95% CI, 8.2-24.5). Median OS was 24.5 months (95% CI, 12-NE) and 12 months OS rate was 63.3% (95% CI, 48.6-74.9). We observed no differences post IO- VEGF OS when comparing IO- TKI vs IO-Bev (Log-rank p = 0.73). CONCLUSIONS: Post IO- VEGF, most patients received VEGFR-TKIs. In this setting, VEGFR-TKIs demonstrated clinical activity and remain a viable option for salvage therapy after progression on IO- VEGF.
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Authors | Yasser Ged, Ruby Gupta, Cihan Duzgol, Andrea Knezevic, Natalie Shapnik, Ritesh Kotecha, Martin H Voss, Darren R Feldman, Oguz Akin, Sujata Patil, Robert J Motzer, Brian I Rini, Chung-Han Lee |
Journal | BMC urology
(BMC Urol)
Vol. 20
Issue 1
Pg. 84
(Jul 02 2020)
ISSN: 1471-2490 [Electronic] England |
PMID | 32616076
(Publication Type: Journal Article)
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Chemical References |
- Antineoplastic Agents
- Receptors, Vascular Endothelial Growth Factor
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Topics |
- Adult
- Aged
- Antineoplastic Agents
(therapeutic use)
- Carcinoma, Renal Cell
(drug therapy)
- Combined Modality Therapy
- Female
- Humans
- Immunotherapy
- Kidney Neoplasms
(drug therapy)
- Male
- Middle Aged
- Receptors, Vascular Endothelial Growth Factor
(antagonists & inhibitors)
- Retrospective Studies
- Withholding Treatment
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