TKIs plus immune checkpoint inhibitors tolerable in metastatic renal cell carcinoma patients

Combination therapy with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors appears to be well tolerated and beneficial in pretreated patients with metastatic renal cell carcinoma (mRCC), suggests a recent study.

The combination therapy was given to 15 patients who had a median of three lines of previous treatment. The median duration of combination therapy was 7.2 months (range, 0.2–39.8).

A total of 126 incidences of toxicities were reported, with fatigue (n=15) as the most frequent, followed by diarrhoea (n=8), anorexia (n=7) and palmar-plantar erythrodysesthesia (n=7). Of the patients, nine (60 percent) had a least one grade 3 or 4 toxicity.

At the 6-month mark, eight patients (53 percent) remained on therapy and did not have progression confirmed by an oncologist. However, 10 of 15 patients discontinued treatment due to progression and two due to intolerable side effects. Two of them transitioned to end-of-life care. One was still undergoing treatment at the time of data collection.

In this study, the authors retrospectively reviewed patients receiving this combination therapy. Their objective was to assess duration of therapy and toxicities, as well as disease progression at 6 months.

Adult patients with confirmed mRCC receiving combination therapy (immune checkpoint inhibitors and TKIs) any time after January 2015 were included. The authors then reviewed electronic medical records for pertinent data and performed follow-up descriptive statistics.

“RCC is a highly vascularized and immunogenic tumour,” the authors said. “At the time of this study, there was limited published data on the combination of TKIs and immune checkpoint inhibitors in patients who were heavily pretreated.”