Clinical Effectiveness of Second-line Sunitinib Following Immuno-oncology Therapy in Patients with Metastatic Renal Cell Carcinoma: A Real-world Study.
BACKGROUND
Limited data exist on the clinical effectiveness of second-line (2L) vascular endothelial growth factor (receptor) targeted inhibitor (VEGF(R)i) sunitinib after first-line (1L) immuno-oncology (IO) therapy for patients with metastatic renal cell carcinoma (mRCC) in real-world settings.


METHODS
A retrospective cohort study among adult patients with mRCC treated with 2L sunitinib following 1L IO was conducted from select International mRCC Database Consortium (IMDC) centers. All analyses were performed overall and by 1L ipilimumab + nivolumab (IPI+NIVO) or 1L IO+VEGF(R)i. Median overall survival (mOS) and time-to-treatment discontinuation (mTTD) in 2L were estimated using Kaplan-Meier analysis. The 2L objective response rate (ORR) (complete/partial response) was reported.


RESULTS
Among 102 patients on 2L sunitinib, mean age was 61.3 years. IMDC risk scores at 2L initiation was available for 83 patients: 8 (9.6%) were favorable, 45 (54.2%) were intermediate, and 30 (36.1%) were poor risk. The 1L consisted of IPI+NIVO in 62 (60.8%), IO+VEGF(R)i therapy in 27 (26.5%), and IO monotherapy in 13 (12.7%) patients. Among all patients, mOS was 15.6 months (95% confidence interval [CI], 9.8-21.7), with a 1-year OS rate of 57.5% (95% CI, 45.2-68.0). mTTD was 5.4 months (95% CI, 4.2-7.2) and ORR was 22.5%.


CONCLUSION
Despite availability of effective 1L therapies in recent years, 2L sunitinib continues to have clinical activity after failure of 1L IO. Further studies on optimal treatment sequencing after 1L IO progression are needed.
['Wells|J Connor|JC|', 'Dudani|Shaan|S|', 'Gan|Chun Loo|CL|', 'Stukalin|Igor|I|', 'Azad|Arun A|AA|', 'Liow|Elizabeth|E|', 'Donskov|Frede|F|', 'Yuasa|Takeshi|T|', 'Pal|Sumanta K|SK|', 'De Velasco|Guillermo|G|', 'Hansen|Aaron R|AR|', 'Beuselinck|Benoit|B|', 'Kollmannsberger|Christian K|CK|', 'Powles|Thomas|T|', 'McGregor|Bradley A|BA|', 'Duh|Mei S|MS|', 'Huynh|Lynn|L|', 'Heng|Daniel Y C|DYC|']
D002292:Carcinoma, Renal Cell D006801:Humans D007680:Kidney Neoplasms D008875:Middle Aged D012189:Retrospective Studies D000077210:Sunitinib D016896:Treatment Outcome D042461:Vascular Endothelial Growth Factor A
Vascular endothelial growth factors Clinical cancer research Immunotherapy Treatment outcomes Tyrosine kinase inhibitor