(197) Real world efficacy and tolerability of axitinib + pembrolizumab in the treatment of renal cell carcinoma

Poster Abstract:

Background: Renal cell carcinoma (RCC) is the most common form of kidney cancer and accounts for approximately 2% of new cancer diagnoses. Combination therapy with immune checkpoint inhibitors (ICIs) and vascular endothelial growth factor tyrosine kinase inhibitors (VEGF TKIs) have demonstrated improved efficacy compared to sunitinib for metastatic RCC (mRCC) and are considered the standard of care in this setting. While three ICI + VEGF TKI combinations are FDA approved for the treatment of mRCC, there are no head-to-head trials comparing these regimens. These combinations are associated with high rates of diarrhea, hypertension, hypothyroidism, plantar-palmar erythrodysesthesia, and rash among other adverse effects, further complicating the management of mRCC. Axitinib + pembrolizumab was the first ICI + VEGF TKI combination to be approved for metastatic renal cell carcinoma. This quality improvement project aims to provide real world data on the safety and efficacy of this combination to further guide clinical decision making in our outpatient oncology clinics.

Methods: This is a retrospective, observational quality improvement project that will be conducted at the Robert H Lurie Comprehensive Cancer Center of Northwestern University in Chicago, Illinois. This project will include patients 18 years of age or older with stage IV RCC who have received axitinib + pembrolizumab as front-line or second-line therapy between April 2019 and July 2023. Data will be collected through manual chart review. Planned endpoints will include progression free survival, overall survival, duration of treatment, and subsequent therapies. Safety endpoints will characterize dose reductions or holds, addition of steroids, types of adverse events, and adverse event management.

Results Pending

References (must also be included in final poster): 1. Motzer, R. J., Jonasch, E., Agarwal, et al. (2023). Kidney Cancer, Version 1.2024, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network, 20(1), 71-90. Retrieved Oct 30, 2023. 
2. Zakharia Y, Thomaidou D, Li B, et al. Real-World Therapy Management and Outcomes of First-Line Axitinib Plus Pembrolizumab in Patients With Advanced Renal Cell Carcinoma in the United States. Front Oncol. 2022 May 19;12:861189. 
3. Rini BI, Plimack ER, Stus V, et al. Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma. N Engl J Med. 2019 Mar 21;380(12):1116-1127.