Emily Menendez

GU Oncology Now

Pembrolizumab/axitinib is approved as a first-line treatment for metastatic renal cell carcinoma (mRCC), but its safety and efficacy in later lines of therapy has not been researched. When used as a first-line treatment, the drug combination has demonstrated superior progression free survival (PFS), objective response rate (ORR), and overall survival compared with sunitinib.<a href="https://www.clinical-genitourinary-cancer.com/article/S1558-7673(23)00002-2/fulltext" target="_blank" rel="noopener">Dizman et al</a> examined clinical data of patients with mRCC who had received pembrolizumab/axitinib in the second line or beyond to determine its effectiveness. Data were collected from Yale New Haven Hospital in Connecticut. Kaplan-Meier function was used to analyze survival, and best objective response was assessed using RECIST 1.1 criteria.The research team analyzed data from 38 patients with a median age of 64 years. A total of 92.1% of patients had clear cell mRCC, while 18.4% had sarcomatoid dedifferentiation. A total of 94.7% of patients had received prior immune checkpoint inhibitors (ICI), and 39.5% had received prior vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGF-R-TKI).Pembrolizumab/axitinib was administered as a second-line therapy in 21 (55.5%) patients, as a third-line therapy in 5 (13.2%) patients, and beyond in 12 (30.2%). At a median follow-up of 17.1 months, the median PFS was 9.7 months (95% CI, 4.1-15.3 months). Out of 36 response evaluable patients, the ORR was 25.0%, and the disease control rate (including stable disease for at least 6 months) was 66.6%.The most common treatment among patients was first-line nivolumab/ipilimumab followed by second-line pembrolizumab/axitinib (n=17, 44.7%). In this cohort, median PFS with pembrolizumab/axitinib was 11.1 months (95% CI, 8.4-13.7 months), with an ORR of 31.4%. Adverse events (AEs) occurred in 86.8% of patients, with grade 3-4 AEs attributed to pembrolizumab and axitinib seen in 18.4% and 6.4% of patients, respectively.The combination treatment of pembrolizumab/axitinib in previously treated patients with mRCC showed activity and demonstrated AE rates comparable with those reported in the first line. Further studies to evaluate ICI-VEGF-R-TKI combinations beyond first-line treatment are needed to determine the best treatment sequencing for mRCC.

Pembrolizumab/Axitinib Combination for mRCC in Further-Line Treatment

Advanced Renal Cell Carcinoma

Researchers examined clinical data of patients with mRCC who had received pembrolizumab/axitinib in the second line or beyond to determine its effectiveness.

Pembrolizumab/Axitinib for mRCC in Further-Line Treatment

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