Most Read Articles
Dr Margaret Shi, 18 May 2020

A blood test is shown to be feasible and safe for early detection of multiple cancers in women with no current or known history of cancer, enabling early treatment with curative intent in a subset of individuals.

Christina Lau, 20 Apr 2020

Hippocampal avoidance during whole-brain radiotherapy (HA-WBRT), together with memantine, better preserves cognitive function vs WBRT plus memantine in patients with brain metastases, without compromising survival, a multi-institutional phase III trial has shown.

Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

Natalia Reoutova, 28 May 2020

Fasting-mimicking diet (FMD) cycles in combination with endocrine therapy (ET) cause metabolic changes in hormone receptor (HR)-positive breast cancer patients analogous to those observed in animal models, where they are associated with anticancer activity.

Tivozanib third-line or fourth-line therapy improves PFS in metastatic renal cell carcinoma

Dr Margaret Shi
02 Jan 2020

Tivozanib as third-line or fourth-line therapy improves progression-free survival (PFS) compared with sorafenib in patients with metastatic renal cell carcinoma (mRCC) who have received ≥2 previous systemic treatments, according to results of the phase III, randomized, controlled TIVO-3 trial.

Over a median follow-up of 19.0 months, tivozanib demonstrated significantly improved independent radiologist review committee (IRC)–assessed PFS (median, 5.6 months vs 3.9 months; hazard ratio [HR], 0.73; 95 percent confidence interval [CI], 0.56 to 0.94; p=0.016) and investigator-assessed PFS (median, 6.0 months vs 5.4 months; HR, 6.2; 95 percent CI, 0.48 to 0.80; p=0.003) vs sorafenib. [Lancet Oncol 2019, doi: 10.1016/S1470-2045(19)30735-1].

Subgroup analyses of PFS by prognostic factors and previous therapy also showed benefit with tivozanib compared with sorafenib, particularly in patients with favourable International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk (HR, 0.46; 95 percent CI, 0.25 to 0.85) and those who previously treated with a checkpoint inhibitor and a VEGFR tyrosine kinase inhibitor (TKI) (HR, 0.55; 95 percent CI, 0.32 to 0.94; p=0.028).

A higher rate of partial response was demonstrated with tivozanib than sorafenib (18 percent vs 8 percent) among patients with measurable disease at baseline. No significant difference was found in the proportion of patients with 1–year duration of response (ie, no disease progression on study) between the tivozanib and sorafenib groups (71 percent vs 46 percent; HR, 0.60; 95 percent CI, 0.22 to 1.61; p=0.33).

No significant difference in overall survival was demonstrated between tivozanib and sorafenib (median, 16.4 months vs 19.7 months; HR, 0.99; 95 percent CI, 0.76 to 1.29; p=0.95).

In the TIVO-3 trial, 350 patients older than 18 years (median age, 63 years) with metastatic RCC who had received 2 previous systemic treatments (including ≥1 previous treatment with a VEGFR inhibitor) were randomized (1:1) to receive either tivozanib 1.5 mg orally once daily or sorafenib 400 mg orally twice daily continuously. Disease progression was the most common reason for treatment discontinuation in both groups.

Tivozanib is a novel VEGFR TKI approved by the European Medicines Agency (EMA) for first-line treatment of adults with advanced RCC. [https://www.ema.europa.eu/en/documents/product-information/fotivda-epar-product-information_en.pdf] Whilst having a potent action on VEGFR, tivozanib’s half-life extends over 4–5 days, which minimizes off-target toxic effects, resulting in improved efficacy and a reduced need for dose interruptions and dose reductions compared with sorafenib. Similar benefits in PFS with tivozanib vs sorafenib have been reported previously in the phase III TIOV-1 trial on first-line treatment of metastatic RCC. [Clin Cancer Res 2011;17:7156-7163; Eur J Cancer 2018;94:87-94]

In the TIVO-3 trial, hypertension (20 percent for tivozanib vs 14 percent for sorafenib) was the most commonly reported grade 3/4 treatment-related adverse event. Serious treatment-related adverse events occurred in 11 percent and 10 percent of patients receiving tivozanib and sorafenib, respectively. No treatment-related deaths were reported.

“Results of TIVO-3 demonstrated a significant improvement in PFS with tivozanib vs sorafenib in patients with highly refractory advanced RCC. Tivozanib also had a favourable safety profile compared with other VEGFR TKIs. These results support tivozanib as a treatment option for patients with advanced RCC, including those who have progressed after previous immunotherapy,” the researchers concluded.

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Most Read Articles
Dr Margaret Shi, 18 May 2020

A blood test is shown to be feasible and safe for early detection of multiple cancers in women with no current or known history of cancer, enabling early treatment with curative intent in a subset of individuals.

Christina Lau, 20 Apr 2020

Hippocampal avoidance during whole-brain radiotherapy (HA-WBRT), together with memantine, better preserves cognitive function vs WBRT plus memantine in patients with brain metastases, without compromising survival, a multi-institutional phase III trial has shown.

Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

Natalia Reoutova, 28 May 2020

Fasting-mimicking diet (FMD) cycles in combination with endocrine therapy (ET) cause metabolic changes in hormone receptor (HR)-positive breast cancer patients analogous to those observed in animal models, where they are associated with anticancer activity.