Comparing Pazopanib, Sunitinib, Cabozantinib, Axitinib-Pembrolizumab, and Ipilimumab-Nivolumab Therapy For Metastatic Renal Cancer
Metastatic renal cell carcinoma (mRCC) poses significant challenges in treatment. Here, we evaluate the outcomes of patients with metastatic renal cell carcinoma treated with upfront nephrectomy followed by pazopanib, sunitinib, cabozantinib, axitinib-pembrolizumab or ipilimumab-nivolumab as first-line therapy. Using a large federated multi-national network database, we identified patients, in the period from 2008 to 2024, who were diagnosed with metastatic renal cell carcinoma, receiving first-line systemic therapies with tyrosine kinase inhibitors or immunomodulator therapy. Pazopanib demonstrated a 57.7% OS rate (138/239 patients), similar to sunitinib (52.6%, 70/180). Cabozantinib showed a trend towards improved OS (56.7%, 102/180) compared to pazopanib, but this was not statistically significant. Ipilimumab-nivolumab had a 63.3% OS (245/387), while axitinib-pembrolizumab exhibited the highest OS rate (70.0%, 21/30) but with a smaller sample size. Although higher relative risk of mortality was associated with ipilimumab-nivolumab use compared to axitinib-pembrolizumab, log-rank testing was not significant. This study investigated the effectiveness of various treatment regimens for mRCC in a real-world setting.
Keywords: mRCC (Metastatic Renal Cell Carcinoma), TKI (tyrosine kinase inhibitor), immunomodulator (IO), Ipilimumab-Nivolumab, Axitinib-Pembrolizumab
