Don’t Rechallenge with an ICI in Renal Cell Carcinoma

According to data presented at the ESMO Congress 2024, being held from September 13–17 in Barcelona, Spain, for patients with advanced renal cell carcinoma, oncologists should avoid prescribing back-to-back immune checkpoint inhibitor (ICI) therapy. In the TiNivo-2 trial, 343 patients whose disease advanced after one or two treatment regimens, including an ICI, were randomly assigned to receive a both the PD1 inhibitor nivolumab (Opdivo; Bristol Myers Squibb) and the VEGFR inhibitor tivozanib (Fotivda; Aveo Oncology) or nivolumab alone (Lancet Sept 13 [Epub ahead of print]). After a median follow up of 12 months, median progression-free survival (PFS) was 5.7 months in the combination arm and 7.4 months with tivozanib alone. Among patients whose most recent treatment was an ICI, the median PFS was 7.4 months and 9.2 months, respectively, pointing to the effectiveness of tivozanib monotherapy as a second-line treatment after ICI therapy. Notably, patients in both groups who hadn’t had an ICI as their most recent treatment had a PFS of just 3.7 months.