For RCC, VEGFR-TKIs Safe, Effective After PD-1 Inhibitors

Share this content:
VEGFR-TKIs are safe and effective after treatment with a PD-1 inhibitor in patients with renal cell carcinoma.
VEGFR-TKIs are safe and effective after treatment with a PD-1 inhibitor in patients with renal cell carcinoma.

Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) are safe and effective after treatment with a programmed cell death 1 (PD-1) inhibitor in patients with metastatic renal cell carcinoma (mRCC), a retrospective study published in the journal Annals of Oncology has shown.1

Because novel agents like nivolumab that block the PD-1 pathway have demonstrated activity in mRCC, researchers sought to evaluate the efficacy and safety of VEGF/VEGFR-TKI therapy following PD-1 inhibition.

For the study, researchers analyzed data from 70 patients with mRCC who were treated with anti-PD-1 antibody monotherapy or in combination, as ipilimumab plus a VEGFR-TKI. Patients were only included if they subsequently received a VEGFR-TKI.

Researchers found that 49 patients received prior therapy with an immune checkpoint inhibitor alone and 21 had combination therapy with an anti-PD-1 inhibitor and a VEGFR-TKI.

Results showed that the objective response rate to VEGFR-TKI therapy after PD-1 inhibition was 28%. Only 10% of patients who received combination therapy achieved a response compared with 36% of those who received a VEGFR-TKI after checkpoint inhibitor therapy alone (P = .039).

The study demonstrated that patients treated with prior checkpoint inhibitor therapy alone had a higher likelihood of achieving an objective response than those treated with anti-PD-1 inhibitor plus a VEGFR-TKI (OR, 5.38; 95% CI, 1.12 - 26.0; P = .03). There was also a trend toward longer progression-free survival in patients who received a VEGFR-TKI after a checkpoint inhibitor alone as compared with those who received combination therapy.

RELATED: Proteinuria Predicts for Renal Functional Decline in Patients With Kidney Cancer

In terms of safety, the most frequently reported adverse events with subsequent VEGFR-TKI therapy were asthenia, hypertension, and diarrhea, suggesting that prior PD-1 exposure did not significantly impact that safety of subsequent VEGFR-TKI treatment.

Reference

  1. Nadal R, Amin A, Geynisman DM, et al. Safety and clinical activity of vascular endothelial growth factor receptor (VEGFR)- tyrosine kinase inhibitors after programmed cell death 1 inhibitor treatment in patients with metastatic clear cell renal cell carcinoma [published online ahead of print April 7, 2016]. Ann Oncol. doi: 10.1093/annonc/mdw160.

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Sign Up for Free e-newsletters



Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs