Salvage lenvatinib/everolimus combination therapy after immune checkpoint inhibitor and VEGFR tyrosine kinase inhibitor for metastatic renal cell carcinoma Article Swipe
Christopher Kwok
,
Adam Khorasanchi
,
Sarah P. Psutka
,
Megan Hinkley
,
Shawn Dason
,
Debasish Sundi
,
Yuanquan Yang
,
Yajing Yang
,
Claire F. Verschraegen
,
Evan Gross
,
Delaney Orcutt
,
Ming Yin
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3389/fonc.2023.1231831
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3389/fonc.2023.1231831
Background The optimal treatment for metastatic renal cell carcinoma (mRCC) patients who have progressed after both immune checkpoint inhibitor (ICI) and VEGFR tyrosine kinase inhibitor (TKI) remains uncertain. Lenvatinib and everolimus (LE) are frequently used in combination as salvage therapy because of their different antitumor mechanisms, but efficacy and toxicity data in this setting are lacking. Methods We retrospectively reviewed charts from two academic centers for 71 adult mRCC patients who received LE after prior ICI and TKI exposure. We evaluated patient demographics, histology, International mRCC Database Consortium (IMDC) risk group, treatment history, and toxicity details. Outcomes of interest included objective response rate (ORR), time to treatment failure (TTF), overall survival (OS), ≥grade 3 toxicities, and schedule or dosage changes, which were evaluated using descriptive statistics, chi-square test, Cox proportional hazards model, and the Kaplan–Meier method. Results The median age was 64 (range 31–84). Most patients had clear cell histology (84.5%) and had undergone nephrectomy (80.3%). IMDC risks were favorable (19.7%), intermediate (int) (66.2%), poor (11.3%), and unknown (2.8%). The average ORR was 26.8%, while the median TTF was 5.5 months (95% confidence interval [CI], 3.5–7.6) and the median OS was 9 months (95% CI, 7.6–12.9). Intermediate and poor IMDC risks were independently associated with a significantly worse TTF compared to favorable risk (hazard ratio (HR), 3.03, 95% CI, 1.18–7.79), as was ≥4L treatment vs. 2L/3L treatment (HR, 2.02, 95% CI, 1.08–3.8). Of the 71 patients, 57.7% had ≥grade 3 adverse events, 60% had treatment interruption, 44.3% had dose reduction, and 21% stopped treatment due to intolerance. Conclusions LE therapy is feasible but has modest efficacies following ICI/TKI treatment. Patients with favorable risk or treated earlier may have a better treatment response. These observations need to be confirmed in prospective studies.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fonc.2023.1231831
- https://www.frontiersin.org/articles/10.3389/fonc.2023.1231831/pdf
- OA Status
- gold
- Cited By
- 2
- References
- 18
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4385304169
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4385304169Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3389/fonc.2023.1231831Digital Object Identifier
- Title
-
Salvage lenvatinib/everolimus combination therapy after immune checkpoint inhibitor and VEGFR tyrosine kinase inhibitor for metastatic renal cell carcinomaWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-07-27Full publication date if available
- Authors
-
Christopher Kwok, Adam Khorasanchi, Sarah P. Psutka, Megan Hinkley, Shawn Dason, Debasish Sundi, Yuanquan Yang, Yajing Yang, Claire F. Verschraegen, Evan Gross, Delaney Orcutt, Ming YinList of authors in order
- Landing page
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https://doi.org/10.3389/fonc.2023.1231831Publisher landing page
- PDF URL
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https://www.frontiersin.org/articles/10.3389/fonc.2023.1231831/pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://www.frontiersin.org/articles/10.3389/fonc.2023.1231831/pdfDirect OA link when available
- Concepts
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Medicine, Lenvatinib, Renal cell carcinoma, Hazard ratio, Everolimus, Internal medicine, Tyrosine-kinase inhibitor, Oncology, Sunitinib, Urology, Cancer, Confidence interval, Thyroid cancerTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
2Total citation count in OpenAlex
- Citations by year (recent)
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2024: 2Per-year citation counts (last 5 years)
- References (count)
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18Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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