Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display session

2076 - Outcomes of patients with metastatic renal cell carcinoma (mRCC) who were treated with second-line (2L) vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKI) after first-line (1L) immune checkpoint inhibitor (ICI) therapy


10 Sep 2017


Poster display session


Amishi Shah


Annals of Oncology (2017) 28 (suppl_5): v295-v329. 10.1093/annonc/mdx371


A.Y. Shah1, E.A. Lemke1, G. Jianjun1, A. Chandamohan1, M.T. Campbell1, A. Zurita Saavedra1, L. Xiao2, J. Wang1, P.G. Corn1, E. Jonasch1, P. Sharma1, N. Tannir1

Author affiliations

  • 1 Genitourinary Medical Oncology, MD Anderson Cancer Center, 77030-4095 - Houston/US
  • 2 Biostatistics, The University of Texas MD Anderson Cancer Center, 77030 - Houston/US


Abstract 2076


ICI therapy is an established strategy in mRCC after progressive disease on VEGFR-TKI. Little data exists in the reverse sequence on response rate, progression-free survival (PFS), safety, and tolerability of TKI after 1L ICI therapy.


This is a retrospective analysis of patients with mRCC treated from 2015 to present with 1L ICI, followed by 2L TKI. Response assessment was provided by a blinded radiologist using RECIST 1.1. Descriptive statistics, Fisher’s test and Wilcoxon rank sum test were used.


We report on 27 clear-cell mRCC patients with follow-up of at least 8 weeks on TKI post 1L ICI. Median age at diagnosis was 58 years. 78% of patients had lung, 37% bone, 37% lymph node, and 7% liver metastasis. As 1L therapy, 7 patients received nivolumab, 17 received nivolumab + ipilimumab, and 3 received nivolumab + bevacizumab. All 27 patients had resolution of Grade 3/4 toxicities from ICI and progressive disease at the time of TKI initiation. Median time from discontinuation of ICI to initiation of TKI was 4.1 weeks (range 0-23.3 weeks). 11 patients (41%) had PR (8 of whom had ≥40% tumor reduction), and 16 (59%) had SD as best response to TKI. Median PFS was 10.0 months (95% CI 6.8, not applicable). 9 patients discontinued 2L TKI after a median of 26.3 weeks (range 4.6-44 weeks), 8 patients because of PD and 1 because of toxicity. 2 patients developed Grade 3 transaminitis and 3 patients Grade 3 hand-foot skin reaction. Age, sex, IMDC risk score, nephrectomy status, and TKI agent did not predict PR or SD.Table:


VariableTotal n (%)PR (n)SD (n)P value
Male19 (70)7120.68
Female8 (30)44
Localized at presentation9 (33)720.01
Metastatic at Presentation18 (67)414
IMDC good risk4 (15)310.47
IMDC intermediate risk19 (70)712
IMDC poor risk4 (15)13
Nephrectomy21 (78)10110.35
Primary in-situ6 (22)15
Pazopanib8 (30)440.37
Axitinib12 (44)39
Cabozantinib7 (26)43


In this small retrospective study, we observed a high response rate (41%), median PFS 10 months, and manageable toxicity in patients with mRCC treated with TKI after ICI. No patients had outright PD on 2L TKI after ICI.

Clinical trial identification

Not applicable (retrospective study)

Legal entity responsible for the study

MD Anderson Cancer Center Dept of Genitourinary Medical Oncology




G. Jianjun: Travel/Honoraria & Consulting: AstraZeneca. M.T. Campbell: Consulting/advisory role: AstraZeneca, Eisai. A. Zurita Saavedra: Research support: Pfizer. E. Jonasch: Research funding: Exelixis, Pfizer, Novartis Honoraria: Bristol-Myers Squib, Eisai, Exelixis, Novartis, Pfizer. P. Sharma: Stock: Jounce, Kite Pharma, Evelo, Neon & Constellation Consulting/advisory role: Bristol-Myers Squib, GSK, AstraZeneca, Amgen, Constellation, Jounce, Kite Pharma, Evelo, Neon & EMC Serono Patents (spouse): Jounce, Merck, Bristol-Myers Squib. N. Tannir: Travel/Honoraria & Consulting: Bristol-Myers Squib, Exelixis, Nektar, Novartis, Pfizer, Argos, Calithera Research: Bristol-Myers Squib, Exelixis, Epizyme, Novartis, Miranti. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.