Real-world treatment patterns and outcomes in metastatic clear cell renal cell carcinoma following immune checkpoint inhibitor progression (2018-2023).

Authors

Neil J Shah, Rahul Ravilla, Andrew J Osterland, Karen Todoroff, Ching-Yu Wang, Pratik Rane, Hakim Saal, Paul R Conkling, Ding Wang, Robert J Motzer

Published in

The oncologist. Sep 15, 2026. Epub Sep 15, 2026.

Abstract

Immune checkpoint inhibitors (ICI) have become standard of care for renal cell carcinoma (RCC) in the adjuvant, first-line and pre-treated settings. However, treatment patterns and outcomes of patients with RCC that progresses following ICI treatment are not well characterized.
A retrospective review of electronic health records from a US community oncology network included patients with metastatic clear cell RCC (mccRCC) that progressed after an initial ICI-containing regimen and received subsequent systemic therapy (index) between 01/01/2018 and 01/31/2023. Patient characteristics and treatment patterns were described. Real-world progression-free survival (rwPFS) and overall survival (OS) were analyzed using Kaplan-Meier method by line of therapy (LOT) of the first ICI-containing regimen and index regimen class.
Overall, 299 patients were included (median [IQR] age 68 [60-75] years, 73% male, 85% white, 87% intermediate or poor IMDC risk, median follow-up 11.3 months) with the first ICI-containing regimen initiated in the adjuvant (n = 5, 2%), first-line (n = 203, 68%) or second-line (n = 91, 30%) settings. Vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) monotherapy was the most common index (post-IO) regimen class (62% any VEGFR-TKI, 46% cabozantinib). Median (95% CI) rwPFS and OS were 6.0 (5.4, 6.8) and 14.3 (12.1, 16.4) months, respectively. No differences were observed in rwPFS and OS by LOT of the first ICI-containing regimen (p = 0.763, p = 0.885, respectively) or index regimen class (p = 0.721, p = 0.747, respectively).
In real-world patients with mccRCC that progressed to the post-ICI setting, VEGFR-TKI monotherapies were the most common post-ICI regimens and differences in clinical outcomes were not observed by LOT of the first ICI-containing regimen or index regimen class. There is high unmet need for novel therapies in the post-ICI setting.

PMID:
42742451
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.