Study Highlights Potential of Combining ICI/TKI Therapy for Renal Cell Carcinoma

Sarah P. Psutka, MD, a urologic oncologist and associate professor in the Department of Urology at the University of Washington Medical Center, discusses the efficacy of the combination of immune checkpoint inhibitor (ICI) therapy plus tyrosine kinase inhibitor (TKI) for the treatment of metastatic renal cell carcinoma.

According to Psutka, the retrospective study looked at 85 patients, 33 of which received frontline immunotherapy or ICI plus TKI. The remaining 52 received this combination in the salvage setting. The overall response rate in the frontline setting was found to 56.7% and 37.5% in the second-line setting. The median progression-free survival (PFS) was 15.2 months in the frontline setting and 14.2 months in the second-line setting.

The combination was found to be safe, with grade 3 or higher adverse events occurring in 52% of patients. Additionally, according to Psutka, patients who received immunotherapy in the frontline setting had a higher objective response rate.

0:08 | This was a study of 85 patients of whom 33 patients received frontline immunotherapy or ICI plus TKI, and 52 patients received this combination therapy in the salvage setting. Our objective response rates with combination ICI-TKI therapy were 56.7% in the frontline setting and then 37.5% overall in the second line setting. PFS was 15.2 months in the frontline setting, compared to 14.2 months in the second line setting.

0:45 | First with respect to safety. In general, this was the second line or salvage utilization of ICI-TKI therapy in this study, appeared to be safe. The grade 3 or greater adverse event rate was 52%. Within that occurred in 25, out of the 52 patients. The objective response rates in patients who were TKI naive in the salvage setting appeared to be the highest. So, patients for example, who'd received ipilimumab [Yervoy] plus nivolumab [Opdivo] as their frontline therapy, those patients had a much higher objective response rate when treated with the combination ICI or IO, TKI therapy in the salvage setting within an objective response rate of 50% and median progression free survival in that group of 9.1 months. And then obviously, we noted as patients were treated with subsequent lines of therapy, the objective response rates and PFS length decreased with each subsequent line of therapy, which is similar to what's been reported previously in the literature.