Abstract
Efficacy of subsequent treatment after combination therapy in non-clear cell renal cell carcinoma (nccRCC)
Journal of clinical oncology, Vol.43(16_suppl), pp.4545-4545
06/2025
DOI: 10.1200/JCO.2025.43.16_suppl.4545
Abstract
4545
Background: The treatment landscape of front-line nccRCC has evolved with recent trials demonstrating the efficacy of combination systemic therapy. However, the efficacy of treatment after combination therapy is unknown. This study evaluates the efficacy of VEGF-based regimens in nccRCC patients (pts) previously treated with combination regimens. Methods: ORACLE is a real-world, multi-center, retrospective database that includes nccRCC patients that received combination systemic therapies (IO+IO, IO+VEGF and VEGF+ mTOR) in any line. Subsequent treatments were categorized as VEGF only regimens (cabozantinib vs other VEGF), IO+ VEGF and VEGF+ mTOR. The primary endpoint was objective response rate (ORR) assessed by investigator review using RECIST 1.1. Secondary endpoints included disease control rate (DCR), defined as the proportion of patients achieving complete or partial responses or stable disease, time to treatment progression (TTP), calculated from the date of VEGF-based initiation to progression or last follow-up using the Kaplan-Meier method. Differences between groups were estimated with the log-rank test, and categorical outcomes were compared with the chi-square test. Results: 105 pts who received VEGF – based regimens after combination therapy were included in the analysis. Baseline characteristics: median age: 59years, 71 % male, 58% white, 25% black, 87% ECOG 0-2. IMDC-risk categories included:21% favorable, 59% intermediate and 20% poor risk. Histology included papillary (40%), unclassified (32%), chromophobe (16%) and other rare subtypes (12%). Prior combination therapies included IO+IO: 62%, IO+ VEGF: 34% and VEGF+ mTORi:4%. 70% pts received combination therapy in the first line setting while the remainder received combination therapy in a second or later line. Outcomes with subsequent treatments are described in Table1. IMDC risk score correlated with TTP. Conclusions: Modest antitumor activity was observed with VEGF- based approaches in combination therapy refractory nccRCC. Optimal management of nccRCC remains an unmet need. Outcomes of nccRCC patients by treatment and histologic type. Outcomes per Treatment n ORR (%) DCR (%) mTTP (mo.) Cabozantinib 56 18 47 3.6 VEGF/mTOR 19 16 42 9.3 IO+VEGF 17 29 47 5.6 Other VEGF 13 15 46 5.5 Outcomes per Histology Papillary 42 19 43 6.5 Unclassified 33 21 42 6.1 Chromophobe 17 29 59 8.9 Other * 13 0 46 NR
Details
- Title: Subtitle
- Efficacy of subsequent treatment after combination therapy in non-clear cell renal cell carcinoma (nccRCC)
- Creators
- Paulo Siqueira do Amaral - Vanderbilt University Medical CenterAniko Szabo - Medical College of WisconsinClara Hwang - Henry Ford HospitalPooja Ghatalia - Fox Chase Cancer CenterAbhishek Tripathi - City Of Hope National Medical CenterHannah Dzimitrowicz McManus - Duke Medical CenterHamid Emamekhoo - University of Wisconsin–MadisonJennifer King - Indiana University HealthBenjamin L. Maughan - University of UtahYousef Zakharia - Mayo Clinic HospitalPedro C. Barata - University Hospitals Seidman Cancer CenterArpita Desai - University of California, San FranciscoMelissa A. Reimers - Washington University in St. LouisYasser Ged - Johns Hopkins MedicineElisabeth I. Heath - Mayo Clinic in ArizonaMehmet Asim Bilen - Emory UniversityJames Brugarolas - The University of Texas Southwestern Medical CenterBrian I. Rini - Vanderbilt University Medical CenterRana R. McKay - University of California, San DiegoDeepak Kilari - Medical College of Wisconsin
- Resource Type
- Abstract
- Publication Details
- Journal of clinical oncology, Vol.43(16_suppl), pp.4545-4545
- DOI
- 10.1200/JCO.2025.43.16_suppl.4545
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 06/2025
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984845671502771
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