Assessing Treatment Patterns in Patients with Metastatic Kidney Cancer

Immune-oncology (IO) agents and tyrosine kinase inhibitors (TKIs) are increasingly being used in the first-line setting of metastatic renal cell carcinoma (mRCC), according to a study presented at the 2022 International Kidney Cancer Symposium: North America.

The research team, led by Neil J. Shah, MD, and colleagues, assessed 1538 patients with mRCC from The US Oncology Network from January 2018 to December 2020. The population of interest received

ipilimumab plus nivolumab (IO+IO), pembrolizumab plus axitinib (IO+TKI), and axitinib or cabozantinib or pazopanib or sunitinib (TKI monotherapy) in the first-line setting.

“We noted a trend toward increased utilization of IO+IO and IO+TKI following their respective [Food and Drug Administration] approvals (IO+IO: April 2018; IO+TKI: April 2019),” the researchers said. During the study period, 35% (n=535), 12% (n=184), and 4% (n=62) of patients with mRCC received second-line, third-line, and fourth-line treatments, respectively. The researchers observed that cabozantinib (49%) and pazopanib (12%), cabozantinib (51%) and ipilimumab plus nivolumab (23%), and nivolumab (45%) and ipilimumab plus nivolumab (20%) were the most common second-line treatments.

“The results show a rapid adaptation of these newer treatments in the community oncology setting,” the researchers concluded. “A longer follow-up is needed to assess their clinical impact and optimal treatment strategy in subsequent settings,” they added.

Source: Shah N, Sura S, Shinde R, et al. Real-world assessment of changing treatment patterns and sequence for patients with metastatic renal cell carcinoma (mRCC) in the first-line (1L) setting. Poster 23. Presented at the 2022 IKCS: North America; November 4-5, 2022; Austin, Texas.