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Review
. 2023 Oct;37(5):965-976.
doi: 10.1016/j.hoc.2023.05.005. Epub 2023 Jun 21.

Managing Metastatic Renal Cell Carcinoma after Progression on Immunotherapy

Regina Barragan-Carrillo  1 , Ameish Govindarajan  2 , Adam Rock  3 , Rubens C Sperandio  4 , Sumanta K Pal  5
Affiliations
Review

Managing Metastatic Renal Cell Carcinoma after Progression on Immunotherapy

Regina Barragan-Carrillo et al. Hematol Oncol Clin North Am. 2023 Oct.

Abstract

Treatment of metastatic renal cell carcinoma (mRCC) after first-line immune checkpoint inhibitors (ICIs) lacks standardization, with limited evidence from small trials and retrospective data. Vascular endothelial growth factor receptor (VEGFR) inhibition through tyrosine kinase inhibitors (TKIs) is the most widely adopted second-line treatment. Encouraging results have been seen with VEGFR-TKIs in the second-line after exposure to an ICI-based combination, achieving a response rate of 30%, and 75% of patients achieving disease control. Rechallenge with ICI alone seems safe but has limited clinical benefit. Promising regimens with combination therapies and novel drugs are being evaluated in phase 3 trials.

Keywords: Immunotherapy; Renal cell carcinoma; Targeted therapy.

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