Subsequent therapy following pembrolizumab plus axitinib or sunitinib treatment for advanced renal cell carcinoma (RCC) in the phase III KEYNOTE-426 study
Authors
Gafanov, R.Powles, T. B.
Bedke, J.
Stus, V.
Waddell, Thomas
Nosov, D.
Pouliot, F.
Soulieres, D.
Melichar, B.
Azevedo, S.
McDermott, R. S.
Vynnychenko, I. O.
Borchiellini, D.
Markus, M.
Bondarenko, I.
Lin, J.
Burgents, J.
Molife, L. R.
Plimack, E. R.
Rini, B.
Affiliation
Urology, Russian Scientific Center of Roentgenoradiology, Moscow, Russian Federa-tion;Issue Date
2021
Metadata
Show full item recordAbstract
Background:In the phase III KEYNOTE-426 study, pembrolizumab + axitinib showedsignificant improvement in OS, PFS, and ORR vs sunitinib in patients with RCC. Thisanalysis assessed subsequent treatment in patients enrolled in KEYNOTE-426.Methods:Treatment-naive patients with clear cell RCC, KPS score =70%, andmeasurable disease (RECIST v1.1) were randomly assigned 1:1 to receive pem-brolizumab 200 mg IV every 3 weeks for up to 35 doses + axitinib 5 mg orally twicedaily or sunitinib 50 mg once daily (4 weeks on/2 weeks off) until progression, toxicity,or withdrawal. Type of and time to subsequent therapy were assessed.Results:Of patients in the pembrolizumab + axitinib arm and in the sunitinib arm,81.4% (349/432) and 90.6% of patients (385/429), respectively, discontinued treat-ment; radiologic or clinical PD was the most common reason for discontinuation inboth (pembrolizumab + axitinib: 65.0% [227/349]; sunitinib: 68.1% [262/385]). Ofpatients who discontinued, 58.5% of patients (204/349) in the pembrolizumab +axitinib arm and 73.0% (281/385) in the sunitinib arm received subsequent therapy(Table). Although a similar proportion of patients in both arms received subsequenttherapy with a VEGF/VEGFR inhibitor (pembrolizumab + axitinib: 88.2% [180/204];sunitinib: 68.7% [193/281]), a greater proportion of patients in the sunitinib arm(74.4% [209/281]) received subsequent PD-1/PD-L1 inhibitor therapy than in thepembrolizumab + axitinib arm (21.6% [44/204]). Of patients in the pembrolizumab +axitinib arm and the sunitinib arm, 32.4% (66/204) and 22.8% (64/281), respectively,received other therapies.Conclusions:The superior efficacy of pembrolizumab + axitinib compared withsunitinib is observed despite the increased use of subsequent therapy in the sunitinibarm. These data continue to support the use offirst-line pembrolizumab + axitinib in patients with RCCCitation
Gafanov R, Powles TB, Bedke J, Stus V, Waddell TS, Nosov D, et al. 669P Subsequent therapy following pembrolizumab + axitinib or sunitinib treatment for advanced renal cell carcinoma (RCC) in the phase III KEYNOTE-426 study. Vol. 32, Annals of Oncology. Elsevier BV; 2021. p. S694.Journal
Annals of OncologyDOI
10.1016/j.annonc.2021.08.065Additional Links
https://dx.doi.org/10.1016/j.annonc.2021.08.065Type
OtherLanguage
enae974a485f413a2113503eed53cd6c53
10.1016/j.annonc.2021.08.065