Utilization and Efficacy of Second-line Targeted Therapy in Metastatic Renal Cell Carcinoma - Beyond the Abstract

There are numerous targeted agents available for the second-line therapy of metastatic renal cell carcinoma (mRCC). Cabozantinib, nivolumab and lenvatinib/everolimus combination are novel options that have become available only recently.  In the face of diverse treatment options and sequences, it is important to re-evaluate the results obtained with currently available drugs in this setting.

The aim of this study was to assess the outcomes of patients treated with second-line agents in the real-world practice based on data from a national registry. Sunitinib-everolimus was the most frequently used sequence (n = 390, 38%), followed by sunitinib-sorafenib (n = 232, 23%), sorafenib-sunitinib (n = 139, 14%) and sorafenib-everolimus (n = 93, 9%).

As shown in the table below, overall survival and combined progression-free survival were similar regardless of the sequence used, although the outcomes were numerically superior for the sunitinib → everolimus sequence. There results provide a benchmark for evaluation of novel second-line agents in mRCC. Patient registries are important tools for assessing various sequencing strategies which are rarely the subject of randomised trials. 

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Written by:

Tomas Buchler, MD, PhD, Associate Professor of Oncology, Department of Oncology First Faculty of Medicine, Charles University and Thomayer Hospital, Czech Republic

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