Real-world outcomes of third-line systemic therapy after immune checkpoint inhibitor combinations and subsequent VEGFR-TKIs in advanced renal cell carcinoma - PubMed

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Study evaluates real-world outcomes of third-line systemic therapy in advanced renal cell carcinoma (RCC) after immune checkpoint inhibitor (ICI) combinations and VEGFR-TKIs.
Retrospective analysis of 35 patients with advanced RCC who received third-line therapy after ICI-based first-line and VEGFR-TKI second-line treatments.
Most common first-line, second-line, and third-line drugs were nivolumab plus ipilimumab (71%), axitinib (60%), and cabozantinib (43%), respectively.
Median progression-free survival (PFS) and overall survival (OS) from third-line therapy initiation were 7.43 and 15.2 months, with an 11% objective response rate.
Clear-cell histology and Karnofsky Performance Status ≥80% were associated with longer OS after multivariable adjustment.
Grade ≥3 adverse events occurred in 37% of patients, with dose reduction, interruption, and discontinuation rates of 40%, 40%, and 14%, respectively.
Subgroup analysis of patients receiving first-line nivolumab plus ipilimumab followed by VEGFR-TKIs showed median PFS and OS of 10.3 and 17.3 months, respectively.
Conclusion: Third-line systemic therapy after ICI combinations and VEGFR-TKIs demonstrates feasible clinical effectiveness and manageable toxicity in advanced RCC patients.

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