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23-05-2018 | Renal cell carcinoma | Article

The efficacy of VEGFR TKI therapy after progression on immune combination therapy in metastatic renal cell carcinoma

British Journal of Cancer

Authors: Pedro Coelho Barata, Alfonso Gomez De Liano, Prateek Mendiratta, Valerie Crolley, Bernadett Szabados, Laura Morrison, Laura Wood, Kimberly Allman, Allison Tyler, Allison Martin, Timothy Gilligan, Petros Grivas, Moshe Ornstein, Jorge A. Garcia, Thomas Powles, Brian I. Rini

Publisher: Nature Publishing Group UK



The outcome of patients who progress on front-line immune-based combination regimens (IC) including immune checkpoint inhibitors (CPI) and receive subsequent systemic therapy is unknown.


Retrospective analysis of consecutive patients with clear-cell mRCC who progressed on one of seven clinical trials investigating an IC and received ≥1 line of subsequent VEGFR TKI therapy.


Thirty-three patients [median age 57 (37–77), 85% male, 73% ECOG 0] were included. For evaluable patients (N = 28), the best response to first subsequent therapy was 29% partial response, 54% stable disease, and 18% progressive disease. The median PFS (mPFS) for first subsequent therapy was 6.4 months (95% CI, 4.4–8.4); no difference in mPFS by prior type of IC (VEGFR TKI-CPI vs. CPI-CPI) was noted (p = 0.310). Significant AEs were observed in 30% of patients, more frequently transaminitis (9%).


VEGFR TKIs have clinical activity in mRCC refractory to IC therapy, possibly impacted by the mechanism of prior combination therapy.

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