Subgroup analyses of a phase III trial comparing tivozanib hydrochloride versus sorafenib as initial targeted therapy for patients (pts) with metastatic renal cell carcinoma (mRCC).

Authors

Thomas Hutson

Thomas E. Hutson

Texas Oncology–Baylor Charles A. Sammons Cancer Center, Dallas, TX

Thomas E. Hutson , Dmitry Nosov , Timothy Eisen , Oleg N. Lipatov , Piotr Tomczak , Anna Alyasova , Mihai Harza , Mikhail Kogan , Boris Y. Alexseev , Cezary Szczylik , Andrew Louis Strahs , Brooke Esteves , Anna Berkenblit , Robert John Motzer

Organizations

Texas Oncology–Baylor Charles A. Sammons Cancer Center, Dallas, TX, Department of Clinical Pharmacology & Chemotherapy, N.N. Blokhin Cancer Research Center, Moscow, Russia, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom, State Budget Medical Institution, Republican Clinical Oncological Center, under the Healthcare Ministry of Bashkortostan Republic, Upa, Russia, Clinical Hospital No. 1 of the Poznan University of Medical Sciences, Poznan, Poland, Federal State Institution, Privolzhsky District Medical Center, under the Federal Medical-Biological Agency of Russia, Nizhny Novgorod, Russia, Fundeni Clinical Institute, Bucharest, Romania, State-Funded Higher Educational Institution, Rostov State Medical University, under the Federal Agency for Healthcare and Social Development of Russia, Rostov-on-Don, Russia, Federal State Institution, Moscow Research Oncological Institute, Moscow, Russia, Military Institute of Health, Warsaw, Poland, AVEO Oncology, Cambridge, MA, Memorial Sloan-Kettering Cancer Center, New York, NY

Research Funding

Pharmaceutical/Biotech Company

Background: Tivozanib hydrochloride (T) is a potent, selective, tyrosine kinase inhibitor of all 3 VEGF receptors with a long half-life. T has shown tolerability and has extended progression-free survival (PFS) compared with sorafenib (S; median 11.9 months vs. 9.1 months; p =0.042) in a phase III trial (TIVO-1) as initial targeted therapy for pts with mRCC. We report results of PFS subgroup analyses from TIVO-1. Methods: Pts with clear-cell mRCC, prior nephrectomy, and ≤1 prior treatment for mRCC were randomized to T (n=260) or S (n=257). Cox proportional hazards model was used to evaluate PFS. Results: Significant improvement in PFS by T vs. S was observed for the following prespecified subgroups: white, Eastern Cooperative Oncology Group (ECOG) performance status 0, ≥1 year since diagnosis, no prior treatment, ≥2 metastatic sites, North America/Western Europe, baseline systolic blood pressure (SBP) ≤140 mm Hg, and baseline diastolic BP (DBP) ≤90 mm Hg. Exploratory subgroup analysis showed a similar significant improvement by T vs. S in Memorial Sloan-Kettering Cancer Center (MSKCC) favorable prognostic group, and pts who developed hypertension on study had significantly longer PFS than pts with normal BP. The improvement in PFS by T vs S was more marked for the subgroups that developed hypertension (selected subgroups shown in the table). Conclusions: PFS subgroup analyses showed a consistent advantage with T vs. S for mRCC. Clinical trial information: NCT01030783.

Median PFS, months (95% confidence interval) P value
Tivozanib
Sorafenib
n n
Prior treatment for mRCC*
No 12.7 (9.1–15.0) 181 9.1 (7.3–10.8) 181 0.037
Yes 11.9 (8.0–16.6) 78 9.1 (7.2–11.1) 76 0.520
ECOG*
0 14.8 (11.3–NA) 116 9.1 (7.5–11.0) 139 0.004
1 9.1 (7.5–12.9) 144 9.0 (7.2–10.9) 118 0.588
MSKCC
Favorable 16.7 (14.7–NA) 70 10.8 (9.0–16.5) 87 0.018
Intermediate 9.4 (8.2–13.0) 173 7.4 (7.1–9.2) 160 0.076
On-study BP,
mm Hg
SBP ≤140 9.0 (7.2–11.3) 144 5.8 (5.5–9.0) 140 0.142
SBP >140 16.7 (12.9–18.3) 115 11.1 (9.2–14.7) 116 0.076
DBP ≤90 9.1 (7.5–12.7) 158 7.3 (5.7–9.1) 169 0.156
DBP >90 18.3 (12.9–NA) 101 11.0 (9.3–16.4) 87 0.154

*Prespecified subgroup; exploratory subgroup; MSKCC poor not included due to low pt numbers.

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Abstract Details

Meeting

2013 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

General Poster Session C: Renal Cancer

Track

Renal Cell Cancer

Sub Track

Renal Cell Cancer

Clinical Trial Registration Number

NCT01030783

Citation

J Clin Oncol 31, 2013 (suppl 6; abstr 354)

DOI

10.1200/jco.2013.31.6_suppl.354

Abstract #

354

Poster Bd #

B7

Abstract Disclosures