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
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 Disclosures
2015 ASCO Annual Meeting
First Author: Thomas Hutson
2021 ASCO Annual Meeting
First Author: Sumanta K. Pal
2021 ASCO Annual Meeting
First Author: Elena Verzoni
2020 ASCO Virtual Scientific Program
First Author: Sumanta K. Pal