Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors

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Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors. / Graham, Jeffrey; Shah, Amishi Y; Wells, J Connor; McKay, Rana R; Vaishampayan, Ulka; Hansen, Aaron; Donskov, Frede; Bjarnason, Georg A; Beuselinck, Benoit; De Velasco, Guillermo; Iafolla, Marco; Duh, Mei S; Huynh, Lynn; Chang, Rose; Zanotti, Giovanni; Ramaswamy, Krishnan; Choueiri, Toni K; Tannir, Nizar M; Heng, Daniel Y C.

I: European urology oncology, Bind 4, Nr. 1, 02.2021, s. 102-111.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Harvard

Graham, J, Shah, AY, Wells, JC, McKay, RR, Vaishampayan, U, Hansen, A, Donskov, F, Bjarnason, GA, Beuselinck, B, De Velasco, G, Iafolla, M, Duh, MS, Huynh, L, Chang, R, Zanotti, G, Ramaswamy, K, Choueiri, TK, Tannir, NM & Heng, DYC 2021, 'Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors', European urology oncology, bind 4, nr. 1, s. 102-111. https://doi.org/10.1016/j.euo.2019.11.001

APA

Graham, J., Shah, A. Y., Wells, J. C., McKay, R. R., Vaishampayan, U., Hansen, A., Donskov, F., Bjarnason, G. A., Beuselinck, B., De Velasco, G., Iafolla, M., Duh, M. S., Huynh, L., Chang, R., Zanotti, G., Ramaswamy, K., Choueiri, T. K., Tannir, N. M., & Heng, D. Y. C. (2021). Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors. European urology oncology, 4(1), 102-111. https://doi.org/10.1016/j.euo.2019.11.001

CBE

Graham J, Shah AY, Wells JC, McKay RR, Vaishampayan U, Hansen A, Donskov F, Bjarnason GA, Beuselinck B, De Velasco G, Iafolla M, Duh MS, Huynh L, Chang R, Zanotti G, Ramaswamy K, Choueiri TK, Tannir NM, Heng DYC. 2021. Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors. European urology oncology. 4(1):102-111. https://doi.org/10.1016/j.euo.2019.11.001

MLA

Vancouver

Graham J, Shah AY, Wells JC, McKay RR, Vaishampayan U, Hansen A o.a. Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors. European urology oncology. 2021 feb;4(1):102-111. https://doi.org/10.1016/j.euo.2019.11.001

Author

Graham, Jeffrey ; Shah, Amishi Y ; Wells, J Connor ; McKay, Rana R ; Vaishampayan, Ulka ; Hansen, Aaron ; Donskov, Frede ; Bjarnason, Georg A ; Beuselinck, Benoit ; De Velasco, Guillermo ; Iafolla, Marco ; Duh, Mei S ; Huynh, Lynn ; Chang, Rose ; Zanotti, Giovanni ; Ramaswamy, Krishnan ; Choueiri, Toni K ; Tannir, Nizar M ; Heng, Daniel Y C. / Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors. I: European urology oncology. 2021 ; Bind 4, Nr. 1. s. 102-111.

Bibtex

@article{bfb2f2deb9804059b4d9ef2bf346a381,
title = "Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors",
abstract = "BACKGROUND: Immuno-oncology (IO) therapies have changed the treatment standards of metastatic renal cell carcinoma (mRCC). However, the effectiveness of targeted therapy following discontinuation of IO therapy in real-world settings has not been well studied.OBJECTIVE: To describe treatment sequence and assess clinical effectiveness of targeted therapy for mRCC patients who received prior IO therapy.DESIGN, SETTING, AND PARTICIPANTS: A retrospective, longitudinal cohort study using data from eight international cancer centers was conducted. Patients with mRCC were ≥18yr old, received IO therapy in any line, and initiated targeted therapy following IO therapy discontinuation.INTERVENTION: Patients were treated with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) or mammalian target of rapamycin inhibitors (mTORIs).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Outcomes were time to treatment discontinuation (TTD), overall survival (OS), and objective response rate (ORR). Crude and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Models were adjusted for age, sex, therapy line, and International Metastatic RCC Database Consortium risk group.RESULTS AND LIMITATIONS: Among 314 patients, 276 (87.9%) and 38 (12.1%) were treated with VEGFR-TKI and mTORI therapy, respectively. The most common tyrosine kinase inhibitor treatments were axitinib, cabozantinib, and sunitinib following IO therapy. In adjusted models, patients treated with VEGFR-TKI versus mTORI therapy had lower hazard of TTD after IO treatment (aHR=0.46; 95% CI: 0.30-0.71; p < 0.01). One-year OS probability (65% vs 47%, p < 0.01) and proportion of ORR (29.8% vs 3.6%, p < 0.01) were significantly greater for patients treated with VEGFR-TKIs versus those treated with mTORIs.CONCLUSIONS: Targeted therapy has clinical activity following IO treatment. Patients who received VEGFR-TKIs versus mTORIs following IO therapy had improved clinical outcomes. These findings may help inform treatment guidelines and clinical practice for patients post-IO therapy.PATIENT SUMMARY: Patients may continue to experience clinical benefits from targeted therapies after progression on immuno-oncology treatment.",
author = "Jeffrey Graham and Shah, {Amishi Y} and Wells, {J Connor} and McKay, {Rana R} and Ulka Vaishampayan and Aaron Hansen and Frede Donskov and Bjarnason, {Georg A} and Benoit Beuselinck and {De Velasco}, Guillermo and Marco Iafolla and Duh, {Mei S} and Lynn Huynh and Rose Chang and Giovanni Zanotti and Krishnan Ramaswamy and Choueiri, {Toni K} and Tannir, {Nizar M} and Heng, {Daniel Y C}",
note = "Copyright {\textcopyright} 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.",
year = "2021",
month = feb,
doi = "10.1016/j.euo.2019.11.001",
language = "English",
volume = "4",
pages = "102--111",
journal = "European urology oncology",
issn = "2588-9311",
publisher = "Elsevier BV",
number = "1",

}

RIS

TY - JOUR

T1 - Outcomes of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy After Immuno-oncology Checkpoint Inhibitors

AU - Graham, Jeffrey

AU - Shah, Amishi Y

AU - Wells, J Connor

AU - McKay, Rana R

AU - Vaishampayan, Ulka

AU - Hansen, Aaron

AU - Donskov, Frede

AU - Bjarnason, Georg A

AU - Beuselinck, Benoit

AU - De Velasco, Guillermo

AU - Iafolla, Marco

AU - Duh, Mei S

AU - Huynh, Lynn

AU - Chang, Rose

AU - Zanotti, Giovanni

AU - Ramaswamy, Krishnan

AU - Choueiri, Toni K

AU - Tannir, Nizar M

AU - Heng, Daniel Y C

N1 - Copyright © 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.

PY - 2021/2

Y1 - 2021/2

N2 - BACKGROUND: Immuno-oncology (IO) therapies have changed the treatment standards of metastatic renal cell carcinoma (mRCC). However, the effectiveness of targeted therapy following discontinuation of IO therapy in real-world settings has not been well studied.OBJECTIVE: To describe treatment sequence and assess clinical effectiveness of targeted therapy for mRCC patients who received prior IO therapy.DESIGN, SETTING, AND PARTICIPANTS: A retrospective, longitudinal cohort study using data from eight international cancer centers was conducted. Patients with mRCC were ≥18yr old, received IO therapy in any line, and initiated targeted therapy following IO therapy discontinuation.INTERVENTION: Patients were treated with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) or mammalian target of rapamycin inhibitors (mTORIs).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Outcomes were time to treatment discontinuation (TTD), overall survival (OS), and objective response rate (ORR). Crude and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Models were adjusted for age, sex, therapy line, and International Metastatic RCC Database Consortium risk group.RESULTS AND LIMITATIONS: Among 314 patients, 276 (87.9%) and 38 (12.1%) were treated with VEGFR-TKI and mTORI therapy, respectively. The most common tyrosine kinase inhibitor treatments were axitinib, cabozantinib, and sunitinib following IO therapy. In adjusted models, patients treated with VEGFR-TKI versus mTORI therapy had lower hazard of TTD after IO treatment (aHR=0.46; 95% CI: 0.30-0.71; p < 0.01). One-year OS probability (65% vs 47%, p < 0.01) and proportion of ORR (29.8% vs 3.6%, p < 0.01) were significantly greater for patients treated with VEGFR-TKIs versus those treated with mTORIs.CONCLUSIONS: Targeted therapy has clinical activity following IO treatment. Patients who received VEGFR-TKIs versus mTORIs following IO therapy had improved clinical outcomes. These findings may help inform treatment guidelines and clinical practice for patients post-IO therapy.PATIENT SUMMARY: Patients may continue to experience clinical benefits from targeted therapies after progression on immuno-oncology treatment.

AB - BACKGROUND: Immuno-oncology (IO) therapies have changed the treatment standards of metastatic renal cell carcinoma (mRCC). However, the effectiveness of targeted therapy following discontinuation of IO therapy in real-world settings has not been well studied.OBJECTIVE: To describe treatment sequence and assess clinical effectiveness of targeted therapy for mRCC patients who received prior IO therapy.DESIGN, SETTING, AND PARTICIPANTS: A retrospective, longitudinal cohort study using data from eight international cancer centers was conducted. Patients with mRCC were ≥18yr old, received IO therapy in any line, and initiated targeted therapy following IO therapy discontinuation.INTERVENTION: Patients were treated with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) or mammalian target of rapamycin inhibitors (mTORIs).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Outcomes were time to treatment discontinuation (TTD), overall survival (OS), and objective response rate (ORR). Crude and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Models were adjusted for age, sex, therapy line, and International Metastatic RCC Database Consortium risk group.RESULTS AND LIMITATIONS: Among 314 patients, 276 (87.9%) and 38 (12.1%) were treated with VEGFR-TKI and mTORI therapy, respectively. The most common tyrosine kinase inhibitor treatments were axitinib, cabozantinib, and sunitinib following IO therapy. In adjusted models, patients treated with VEGFR-TKI versus mTORI therapy had lower hazard of TTD after IO treatment (aHR=0.46; 95% CI: 0.30-0.71; p < 0.01). One-year OS probability (65% vs 47%, p < 0.01) and proportion of ORR (29.8% vs 3.6%, p < 0.01) were significantly greater for patients treated with VEGFR-TKIs versus those treated with mTORIs.CONCLUSIONS: Targeted therapy has clinical activity following IO treatment. Patients who received VEGFR-TKIs versus mTORIs following IO therapy had improved clinical outcomes. These findings may help inform treatment guidelines and clinical practice for patients post-IO therapy.PATIENT SUMMARY: Patients may continue to experience clinical benefits from targeted therapies after progression on immuno-oncology treatment.

U2 - 10.1016/j.euo.2019.11.001

DO - 10.1016/j.euo.2019.11.001

M3 - Journal article

C2 - 31786162

VL - 4

SP - 102

EP - 111

JO - European urology oncology

JF - European urology oncology

SN - 2588-9311

IS - 1

ER -