Dr Shah on Real-World Treatment and Outcomes in Metastatic RCC After IO/TKI Combos

Neil J. Shah, MBBS, assistant attending physician, genitourinary oncologist, Memorial Sloan Kettering Cancer Center, discusses real-world treatment patterns and clinical outcomes in patients with metastatic renal cell carcinoma (RCC) following immuno-oncology (IO) and VEGF TKIs combination therapy.

The study analyzed clinical outcomes across a diverse cohort of patients with metastatic RCC treated in a real-world setting throughout the United States. Specifically, the focus was on patients who had received either an IO/TKI combination or received these therapies sequentially. The analysis aimed to identify treatment patterns and their impact on overall survival (OS) in later-line settings.

Key findings presented at the 2024 Kidney Cancer Research Summit showed the wide variability in the therapeutic agents used after initial IO and TKI therapy. Cabozantinib (Cometriq) emerged as one of the most commonly used drugs in the post IO/TKI setting, Shah explains; however, he notes that there was significant diversity with the use of other agents as monotherapy and combination therapy, including other IO/TKI combinations.

Surprisingly, despite the diversity of the treatment regimens used in the post-IO/TKI setting, Shah notes no single agent or combination was associated with superiority in terms of OS. The lack of a clear frontrunner in this treatment setting highlights the heterogeneity of treatment practices and outcomes in a real-world clinical setting, he says.

Moreover, Shah notes that a short median OS observed for various subsequent therapies in the post-IO/TKI setting for patients with metastatic RCC underscores the limited effectiveness of current therapeutic options in this setting. These findings suggest a pressing need for novel therapeutic agents and strategies to improve survival outcomes for patients with metastatic RCC patients who have experienced disease progression after IO and TKI therapy, he concludes.