ASCO GU 2019: Evolving Management of Metastatic Renal Cell Carcinoma

When it comes to drugs used to treat metastatic renal cell carcinoma, one of the differentiating features is tolerability. With each drug, there will be a unique tolerability profile for each specific patient with kidney cancer. In general, since these drugs are not curative, the goal is to get patients to have more control of the disease, not necessarily cure them. 

Furthermore, the biology of kidney cancer is that vascular endothelial growth factor (VEGF) is really the target for these cancer drugs. Tivozanib is a more potent and tolerable VEGF inhibitor especially for kidney cancer, according to Brian Rini, MD, FACP of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.

Doximity caught up with Rini ahead of ASCO GU 2019 to ask about the research he will be presenting at the conference, "Abstract 541: TIVO-3: A phase III, randomized, controlled, multi-center, open-label study to compare tivozanib to sorafenib in subjects with refractory advanced renal cell carcinoma". An excerpt from the interview can be read below.

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Doximity: What can attendees expect to take away from your session at ASCO GU titled "General Session 8: Evolving Management of Metastatic Renal Cell Carcinoma"?

Brian Rini: This is a phase III trial that followed on previous trails tivozanib over the past three years. The main result was that the trial was positive for the primary endpoint of progression-free survival. There was a significant advantage to tivozanib over sorafenib for progression-free survival, largely in the third- and fourth-line settings for patients with kidney cancer.

Doximity: What else is exciting about this particular study?

Rini: It’s one of the only ones that has been positive in this refractory of a setting. In kidney cancer, prior treatments required one to two treatments, while this allowed two to three prior treatments and now kidney cancer patients are living longer. They are getting exposed to more treatments and that’s a good thing. It’s nice to have level one evidence of beneficiary in such a refractory setting.

Doximity: How can this research be implemented in a clinical setting?

Rini: Right now, tivozanib is not approved in the U.S. so hopefully this data will contribute to its approval. It’s approved in Europe.

Doximity: What are some future directions that you are excited about in your research, as well as the field in general?

Rini: In general, immuno-oncology has been taking over kidney cancer. There’s big data that opened up at ASCO GU about a combination regimen already approved and more. Ultimately, we are coming soon to a point where all kidney cancer patients will receive an immunotherapy-based regimen as initial treatment.

In relation to the data that I’m presenting about, tivozanib is a drug that’s really well tolerated and will probably combine well with immunotherapies moving forward.

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