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Real-world Clinical Outcomes of Pazopanib Immediately After Discontinuation of Immunotherapy for Advanced Renal Cell Carcinoma.

Abstract：

INTRODUCTION:In the first-line (1L) setting, pazopanib (PAZ) has been recommended by the National Comprehensive Cancer Network for the treatment of advanced renal cell carcinoma (aRCC). In 2018, immuno-oncology (IO) therapy became a commonly used 1L treatment option for aRCC. We report the real-world clinical outcomes of PAZ after IO therapy for patients with aRCC. MATERIALS AND METHODS:We performed a longitudinal, retrospective medical record review study. The included patients were aged ≥ 18 years, had initiated second-line and/or beyond PAZ after IO therapy for clear cell aRCC on or before October 2017, and had complete medical records available from the diagnosis of aRCC to the discontinuation of PAZ, death, or the medical record extraction date (May 2018), whichever occurred first. The primary outcome variable was the PAZ duration of therapy. The secondary outcomes were progression-free survival and overall survival since PAZ initiation, the reasons for PAZ discontinuation, and the occurrence of adverse events (AEs). RESULTS:A total of 258 eligible patients had initiated IO therapies before PAZ as follows: nivolumab (68%), nivolumab plus ipilimumab (14%), pembrolizumab (12%), and ipilimumab (3%). Overall, the median PAZ duration of therapy was 13.4 months (95% confidence interval [CI], 10.1-16.0 months). The median progression-free survival with PAZ after IO therapy was 13.5 months (95% CI, 11.8 months to not reached). The estimated overall survival rate of PAZ after IO therapy at 6 and 12 months was 93% and 89%, respectively. A total of 109 patients (42%) had reported an AE. The most frequently reported AEs were fatigue (29%) and diarrhea (14%). No additional safety signal of hepatotoxicity was observed (increased aspartate aminotransferase, 5%; increased alanine transaminase, 6%). CONCLUSIONS:In the present real-world study, second-line and/or beyond PAZ after previous IO therapy was well-tolerated and effective for patients with aRCC.

journal_name

Clin Genitourin Cancer

journal_title

Clinical genitourinary cancer

authors

Cao X,Tang D,Ratto B,Poole A,Ravichandran S,Jin L,Gao W,Swallow E,Vogelzang NJ

doi

10.1016/j.clgc.2019.10.010

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

e37-e45

issue

eissn

1558-7673

issn

1938-0682

pii

S1558-7673(19)30314-3

journal_volume

pub_type

杂志文章,多中心研究

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Real-world Clinical Outcomes of Pazopanib Immediately After Discontinuation of Immunotherapy for Advanced Renal Cell Carcinoma.