晚期疾病的后续治疗.pdf

1、Subsequent-Line Treatment for Advanced DiseaseRobert J.Motzer,MDJack and Dorothy Byrne Chair in Clinical OncologyAttending Physician and Member,MSKCCWhats new for KCRS 2025?TKIs HIF inhibitors Cellular therapy Drugs with Novel MOA Relapse to adjuvant pembrolizumabEXCLUSION ZONENCCN Guidelines Versio

2、n 1.2025 Kidney CancerEXCLUSION ZONEPhase III trials assess the role of TKI/IO After Prior IO therapyTivozanibTivozanib+NivolumabR1:1ccRCC PD during or after prior ICI treatment1-2 prior linesICI not necessarily most recentN=343CabozantinibAtezolizumab+CabozantinibR1:1ccRCC PD during or after prior

3、ICI treatment1-2 prior linesICI in the immediately preceding line of therapyN=522Pal et al.Lancet.2023.Choueiri et al.ESMO 2024,Lancet.2024.100806040200171172118120768561581722108100Time since randomization(months)PFS per IRR(%)03691215182124No.at riskEXCLUSION ZONETiNIVO-2,Centrally Reviewed PFS by

4、 Most Recent Line of TherapyChoueiri T et al,ESMO 2024;HR,hazard ratio;ICI,immune checkpoint inhibitor;IRR,independent radiology review;PFS,progression-free survivalICI as Most Recent TherapyNon-ICI as Most Recent TherapyTivozanib+Nivolumab(n=122)Tivozanib(n=122)PFS events,n(%)78(64)75(61)Median PFS

5、(95%CI),mo7.4(5.6-9.6)9.2(7.4-10.0)HR(95%CI)1.10(0.80-1.52);p=0.5574Tivozanib+Nivolumab(n=49)Tivozanib(n=50)PFS events,n(%)40(82)37(74)Median PFS(95%CI),mo3.7(2.7-5.4)3.7(1.9-7.2)HR(95%CI)0.95(0.61-1.50);p=0.8457010050750No.at riskTivozanib+NivolumabTivozanib2536912PFS per IRR(%)15182124122896147148

6、101229468492080CensoredTime since randomization(months)010050750Tivozanib+NivolumabTivozanib2536912Time since randomization(months)PFS per IRR(%)1518212449291514320502617920CensoredNo.at riskEXCLUSION ZONETiNivo-2 All-Grade Adverse Events6Adverse event,n(%)aTivozanib 0.89 mg+Nivolumab(n=168)Tivozani