Background: First-line therapy for mRCC pts includes immuno-combinations, although TKI monotherapy is an alternative option for IMDC favorable-risk pts. In-vitro studies reported that pazopanib has greater immunomodulatory activity than sunitinib, but validated criteria for selecting TKIs as first-line therapy are missing. Methods: The Meet-URO 15 study retrospectively evaluated 571 pre-treated mRCC pts who received second-line Nivolumab. The study analyzed the correlation between overall response rates (ORR), disease control rates (DCR), and survival outcomes (including median progression free and overall survival rates - mPFS, mOS), and the previous TKI (either sunitinib or pazopanib). It was also examined interaction between TKI choice and the IMDC prognostic groups. Results: Out of 571 pts (PMID: 34046089), 538 (94%) received prior treatment with sunitinib (N = 352, 65.4%) or pazopanib (N = 186, 34.6%). Overall, the mOS, mPFS, ORR, and DCR were 23.9 months, 6.9 months, 30.7%, and 60.8%, respectively. There were no significant differences between the two groups in terms of mOS (24.9 vs. 20.7 months; p = 0.92), mPFS (6.6 vs. 7.9 months; p = 0.62), ORR (29.2% vs. 33.3%; p = 0.33), or DCR (59.6% vs. 62.9%; p = 0.46). OS was similar in the two groups also when patients were stratified according to the IMDC score: IMDC favorable-risk pts (N = 70 and 50) (HR 0.82, 0.49 – 1.37) and intermediate-poor risk pts (N = 278 and 136) (HR 1.15, 0.91-1.48) (p for interaction = 0.16). Similarly, there were no significant differences in PFS between sunitinib and pazopanib when comparing IMDC favorable-risk pts (HR 0.94, 0.63-1.42) and intermediate-poor risk pts (HR 1.01, 0.81-1.25) (p for interaction = 0.68). Similar data were observed for ORR and DCR (p for interaction: 0.60 and 0.41, respectively). Conclusions: The prior use of sunitinib or pazopanib in mRCC pts who received second-line nivolumab did not show any significant differences in mOS, mPFS, ORR, and DCR, without significant differences comparing IMDC favorable and intermediate/poor risk. There is currently no evidence to support a preference for either pazopanib or sunitinib before administering nivolumab.
Clinical relevance of first-line tyrosine kinase inhibitor (TKI) choice in metastatic renal cell carcinoma (mRCC) patients (pts) receiving second-line nivolumab (Meet-URO 15 study) / Catalano, F.; Signori, A.; Sorarù, M.; Malgeri, A.; Di Napoli, M.; Caffo, O.; Vignani, F.; Cavo, A.; Roviello, G.; Prati, V.; Tudini, M.; Atzori, F.; Messina, M.; Damassi, A.; Morelli, F.; Prati, G.; Nolè, F.; Rescigno, P.; Buti, S.; Rebuzzi, S. E.. - In: TUMORI. - ISSN 0300-8916. - 109:2_suppl(2023), pp. A59.41-A59.41. [10.1177/03008916231203496]
Clinical relevance of first-line tyrosine kinase inhibitor (TKI) choice in metastatic renal cell carcinoma (mRCC) patients (pts) receiving second-line nivolumab (Meet-URO 15 study).
Buti S.Conceptualization
;
2023-01-01
Abstract
Background: First-line therapy for mRCC pts includes immuno-combinations, although TKI monotherapy is an alternative option for IMDC favorable-risk pts. In-vitro studies reported that pazopanib has greater immunomodulatory activity than sunitinib, but validated criteria for selecting TKIs as first-line therapy are missing. Methods: The Meet-URO 15 study retrospectively evaluated 571 pre-treated mRCC pts who received second-line Nivolumab. The study analyzed the correlation between overall response rates (ORR), disease control rates (DCR), and survival outcomes (including median progression free and overall survival rates - mPFS, mOS), and the previous TKI (either sunitinib or pazopanib). It was also examined interaction between TKI choice and the IMDC prognostic groups. Results: Out of 571 pts (PMID: 34046089), 538 (94%) received prior treatment with sunitinib (N = 352, 65.4%) or pazopanib (N = 186, 34.6%). Overall, the mOS, mPFS, ORR, and DCR were 23.9 months, 6.9 months, 30.7%, and 60.8%, respectively. There were no significant differences between the two groups in terms of mOS (24.9 vs. 20.7 months; p = 0.92), mPFS (6.6 vs. 7.9 months; p = 0.62), ORR (29.2% vs. 33.3%; p = 0.33), or DCR (59.6% vs. 62.9%; p = 0.46). OS was similar in the two groups also when patients were stratified according to the IMDC score: IMDC favorable-risk pts (N = 70 and 50) (HR 0.82, 0.49 – 1.37) and intermediate-poor risk pts (N = 278 and 136) (HR 1.15, 0.91-1.48) (p for interaction = 0.16). Similarly, there were no significant differences in PFS between sunitinib and pazopanib when comparing IMDC favorable-risk pts (HR 0.94, 0.63-1.42) and intermediate-poor risk pts (HR 1.01, 0.81-1.25) (p for interaction = 0.68). Similar data were observed for ORR and DCR (p for interaction: 0.60 and 0.41, respectively). Conclusions: The prior use of sunitinib or pazopanib in mRCC pts who received second-line nivolumab did not show any significant differences in mOS, mPFS, ORR, and DCR, without significant differences comparing IMDC favorable and intermediate/poor risk. There is currently no evidence to support a preference for either pazopanib or sunitinib before administering nivolumab.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
