Activity of lenvatinib-based therapy in previously treated patients with metastatic renal cell carcinoma: A European multicenter study (LENVA-LAT)

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer Pub Date : 2025-03-26 DOI:10.1016/j.ejca.2025.115389

Javier Gavira , Edouard Auclin , Macarena Rey-Cardenas , Pritha Roy , Jose C. Tapia , Paula Nay , Armelle Vinceneux , Felix Lefort , Simon Nannini , Adela Maria del Carmen Randis , Natacha Naoun , Bernard Escudier , Delphine Borchiellini , Guillermo de Velasco , Philippe Barthelemy , Marine Gross-Goupil , Sylvie Negrier , Stéphane Oudard , Ricky D. Frazer , Laurence Albiges , Ronan Flippot

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引用次数: 0

Abstract

Background and Objective

Lenvatinib’s activity after immune checkpoint inhibitors (ICI) combination therapy in renal cell carcinoma (RCC) remains unknown. We aimed to describe the real-world outcomes of patients with metastatic RCC (mRCC) treated with lenvatinib after failure of the prior standard of care.

Methods

Multicenter retrospective study including patients with mRCC treated with lenvatinib-based therapies beyond first-line therapy between 2020 and 2024. The primary endpoints were objective response rate (ORR) and time-to-treatment failure (TTF). Secondary endpoints included disease control rate (DCR), overall survival (OS), and safety.

Results

We included 133 patients, with a median age of 61 years. Clear-cell was the main subtype (82.0 %). Before lenvatinib treatment, 15.8 %, 51.9 %, and 27.8 % of patients showed favorable, intermediate, and poor risk disease, respectively, according to the International Metastatic RCC Database Consortium (IMDC). Moreover, patients received a median of 3 previous lines of treatment, including ICIs (90.2 %) and cabozantinib (90.2 %). Lenvatinib was given alone (45.9 %) or in combination with everolimus (33.8 %), pembrolizumab (18.0 %) or investigational agents (2.3 %). The ORR and DCR were 29.1 % and 67.7 %, respectively, with no differences between regimens or lines of treatment. With a median follow-up time of 13.5 months, the median TTF and OS were 6.2 and 9.6 months. Toxicity was manageable with dose modifications required in 34.6 %. The discontinuation rate was 9.8 %, with one toxic death.

Conclusion

Lenvatinib-based regimens were active and safe for heavily pre-treated patients with mRCC. These findings provide evidence to support its use in daily practice.

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lenvatinib为基础治疗转移性肾癌患者的活性：一项欧洲多中心研究（LENVA-LAT）

背景与目的免疫检查点抑制剂（ICI）联合治疗肾细胞癌（RCC）后，envatinib的活性尚不清楚。我们的目的是描述在先前的标准治疗失败后，用lenvatinib治疗的转移性RCC （mRCC）患者的真实结果。方法采用多中心回顾性研究，纳入2020年至2024年一线治疗之外接受lenvatinib为基础治疗的mRCC患者。主要终点为客观缓解率（ORR）和治疗失败时间（TTF）。次要终点包括疾病控制率（DCR）、总生存期（OS）和安全性。结果纳入133例患者，中位年龄61岁。清细胞型为主要亚型（82.0 %）。根据国际转移性RCC数据库联盟（IMDC）的数据，lenvatinib治疗前，15.8% %、51.9% %和27.8% %的患者分别表现为有利、中等和低风险疾病。此外，患者接受了中位数为3个既往治疗线，包括ICIs（90.2 %）和cabozantinib（90.2 %）。Lenvatinib单独使用（45.9% %）或与依维莫司（33.8% %）、派姆单抗（18.0% %）或研究用药物（2.3 %）联合使用。ORR和DCR分别为29.1% %和67.7% %，不同治疗方案或治疗线之间无差异。中位随访时间为13.5个月，中位TTF和OS分别为6.2和9.6个月。34.6%（ %）需要剂量调整，毒性是可控的。停药率为9.8% %，1例中毒性死亡。结论lenvatinib为基础的方案对重度预处理的mRCC患者有效且安全。这些发现为支持在日常实践中使用它提供了证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Cancer 医学-肿瘤学

CiteScore

11.50

自引率

4.80%

发文量

953

审稿时长

23 days

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