Efficacy of targeted therapies after PD-1/PD-L1 blockade in metastatic renal cell carcinoma

Monoclonal antibodies that target the programmed death-1 (PD-1)/programmed death-ligand 1(PD-L1) pathway have shown antitumour activity in metastatic renal cell carcinoma (mRCC) and are currently being developed in first-line (in combination) and in previously treated patients.

The efficacy targeted therapy (TT) after PD-1/PD-L1 blockade is still unknown.

Medical records of mRCC patients treated with investigational PD-1 or PD-L1 inhibitors at 4 academic institutions were reviewed. Patients who received subsequent treatment with TT were selected to collect outcome measures of subsequent TT.

Of 99 patients who received PD-1/PD-L1 blockade as part of clinical trials, 56 patients have received subsequent therapy: 44 patients received vascular endothelial growth factor (VEGF)/vascular endothelial growth factor receptor (VEGFR) inhibitors and 12 received mammalian target of rapamycin (mTOR) inhibitors as first subsequent TT. Median follow up, from the start of subsequent TT was 16. 1months (range: 0. 2, 30. 6months). TT post PD-1/PD-L1 blockade was administered as second-line, third-line or beyond third-line in 9 (16%), 24 (43%) and 23 patients (41%) respectively. Median time to treatment failure on subsequent TT was 6. 6months (range: 0. 2+, 23. 0). 1-year and 2year overall survival from the initiation of subsequent TT was 58% (95% confidence interval (CI): 41-72%) and 36% (95% CI: 18-54%), respectively.

Both VEGF/VEGFR and mTOR inhibitors demonstrate antitumour activity following PD-1/PD-L1 blockade.

European journal of cancer (Oxford, England : 1990). 2015 Sep 04 [Epub ahead of print]

Laurence Albiges, André P Fay, Wanling Xie, Katherine Krajewski, David F McDermott, Daniel Y C Heng, Charles Dariane, Guillermo DeVelasco, Renee Lester, Bernard Escudier, Toni K Choueiri

Kidney Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, United States; Gustave Roussy Cancer Campus, University of Paris Sud, Department of Cancer Medicine, Villejuif, France. , Kidney Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, United States. , Kidney Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, United States. , Kidney Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, United States. , Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States; Kidney Cancer Program, Dana-Farber Harvard Cancer Center, Boston, United States. , Tom Baker Cancer Center and University of Calgary, Calgary, Canada. , Gustave Roussy Cancer Campus, University of Paris Sud, Department of Cancer Medicine, Villejuif, France. , Kidney Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, United States. , Kidney Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, United States. , Gustave Roussy Cancer Campus, University of Paris Sud, Department of Cancer Medicine, Villejuif, France. , Kidney Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, United States; Kidney Cancer Program, Dana-Farber Harvard Cancer Center, Boston, United States.  

PubMed

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