In an international multicenter randomised phase 3 clinical trial led by Dr Toni K.Choueiri and Dr Bradley McGregor of the Dana-Farber Cancer Institute, researchers tested the addition of the immune checkpoint inhibitor (ICI) nivolumab to treatment with tivozanib for patients with advanced clear cell renal cell carcinoma, a form of kidney cancer.

The research was published in the The Lancet and presented at the European Society for Medical Oncology 2024.

Tivozanib, a vascular endothelial growth factor receptor tyrosine kinase inhibitor, has antiangiogenic effects and is thought to be synergistic with an ICI.

Eligible patients had received one or two prior lines of therapy, including an ICI.

The addition of nivolumab, a PD-1 inhibitor, to tivozanib did not delay the progression of cancer, nor improve overall survival or response rates compared to tivozanib monotherapy according to the team’s analysis.

This was true whether the patient received an ICI in their most recent prior therapy or earlier.

Immune checkpoint inhibitors such as those that block PD-1 and PD-L1 have revolutionised cancer therapy and become part of standard first-line therapy for many solid tumours, including for advanced kidney cancer.

Questions remain about how best to sequence treatment with an ICI after progression on prior ICI.

This study is only the second to ask such a question.

Repeat ICI therapy should be discouraged in patients with advanced renal cell carcinoma.

Source: Dana-Farber Cancer Institute