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

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.

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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References:

Lakomy R, Poprach A, Bortlicek Z, Melichar B, Chloupkova R, Vyzula R, Zemanova M, Kopeckova K, Svoboda M, Slaby O, Kiss I, Studentova H, Juracek J, Fiala O, Kopecky J, Finek J, Dusek L, Hejduk K, Buchler T. Utilization and efficacy of second-line targeted therapy in metastatic renal cell carcinoma: data from a national registry. BMC Cancer. 2017 Dec 21;17(1):880. doi: 10.1186/s12885-017-3901-5.

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