Impact of first-line tyrosine kinase inhibitor selection on survival outcomes with second-line nivolumab in metastatic renal cell carcinoma
Abstract Introduction Access to first-line immune checkpoint inhibitor (ICI) combinations in metastatic renal cell carcinoma (mRCC) remains limited in many low- and middle-income countries. Consequently, tyrosine kinase inhibitors (TKIs) are still widely used. This study investigates the impact of f...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12885-025-14654-3 |
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| author | Omer Faruk Kuzu Hatice Bolek Elif Sertesen Camoz Hilal Karakas Serhat Sekmek Saadet Sim Selver Isık Murat Günaltılı Aysun Fatma Akkus Deniz Tural Cagatay Arslan Sema Sezin Goksu Ozlem Nuray Sever Cengiz Karacin Mehmet Ali Nahit Sendur Nuri Karadurmus Emre Yekedüz Yüksel Ürün |
| author_facet | Omer Faruk Kuzu Hatice Bolek Elif Sertesen Camoz Hilal Karakas Serhat Sekmek Saadet Sim Selver Isık Murat Günaltılı Aysun Fatma Akkus Deniz Tural Cagatay Arslan Sema Sezin Goksu Ozlem Nuray Sever Cengiz Karacin Mehmet Ali Nahit Sendur Nuri Karadurmus Emre Yekedüz Yüksel Ürün |
| author_sort | Omer Faruk Kuzu |
| collection | DOAJ |
| description | Abstract Introduction Access to first-line immune checkpoint inhibitor (ICI) combinations in metastatic renal cell carcinoma (mRCC) remains limited in many low- and middle-income countries. Consequently, tyrosine kinase inhibitors (TKIs) are still widely used. This study investigates the impact of first-line sunitinib versus pazopanib on survival outcomes with second-line nivolumab. Methods We conducted a retrospective analysis of 245 patients with mRCC from the Turkish Oncology Group Kidney Cancer Consortium Database. Patients received first-line sunitinib or pazopanib, followed by second-line nivolumab. Primary endpoints were time to treatment failure (TTF) and overall survival (OS). Subgroup analyses were performed based on IMDC risk classification and presence of sarcomatoid features. Results A total of 245 patients who were treated with sunitinib or pazopanib monotherapy as first-line treatment followed by nivolumab as second-line treatment were included in this study. Median TTF following nivolumab initiation was similar between prior sunitinib and pazopanib groups (7.79 vs 7.72 months; p = 0.892). Median OS-2 was 27.21 months with prior sunitinib and 18.92 months with prior pazopanib (p = 0.496). In patients with sarcomatoid features (n = 20), those pretreated with pazopanib demonstrated numerically longer OS-2 compared to sunitinib (p = 0.023), although the small sample size limits definitive conclusions. Conclusion No significant differences in survival outcomes were observed between first-line sunitinib and pazopanib before nivolumab in mRCC. In the small subgroup with sarcomatoid features, pazopanib pre-treatment was associated with a numerically longer survival. These findings warrant cautious interpretation and further prospective validation, especially in resource-constrained settings. |
| format | Article |
| id | doaj-art-ef9e58d2bf4e4ddc93bfbceafb8565ca |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj-art-ef9e58d2bf4e4ddc93bfbceafb8565ca2025-08-20T03:42:51ZengBMCBMC Cancer1471-24072025-07-012511910.1186/s12885-025-14654-3Impact of first-line tyrosine kinase inhibitor selection on survival outcomes with second-line nivolumab in metastatic renal cell carcinomaOmer Faruk Kuzu0Hatice Bolek1Elif Sertesen Camoz2Hilal Karakas3Serhat Sekmek4Saadet Sim5Selver Isık6Murat Günaltılı7Aysun Fatma Akkus8Deniz Tural9Cagatay Arslan10Sema Sezin Goksu11Ozlem Nuray Sever12Cengiz Karacin13Mehmet Ali Nahit Sendur14Nuri Karadurmus15Emre Yekedüz16Yüksel Ürün17Department of Medical Oncology, Gulhane Training and Research Hospital, University of Health SciencesDepartment of Medical Oncology, Ankara University School of MedicineDepartment of Medical Oncology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health SciencesDepartment of Medical Oncology, Ankara Bilkent City HospitalDepartment of Medical Oncology, Ankara Bilkent City HospitalDepartment of Medical Oncology, Ege University School of MedicineDepartment of Medical Oncology, Marmara University School of MedicineDepartment of Medical Oncology, Cerrahpasa School of MedicineDepartment of Medical Oncology, Trakya University School of MedicineDepartment of Medical Oncology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health SciencesMedical Point Hospital, Izmir University of EconomicsDepartment of Medical Oncology, Akdeniz University School of MedicineDepartment of Medical Oncology, Kartal Dr. Lutfi Kirdar City HospitalDepartment of Medical Oncology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health SciencesDepartment of Medical Oncology, Ankara Bilkent City HospitalDepartment of Medical Oncology, Gulhane Training and Research Hospital, University of Health SciencesDepartment of Medical Oncology, Ankara University School of MedicineDepartment of Medical Oncology, Ankara University School of MedicineAbstract Introduction Access to first-line immune checkpoint inhibitor (ICI) combinations in metastatic renal cell carcinoma (mRCC) remains limited in many low- and middle-income countries. Consequently, tyrosine kinase inhibitors (TKIs) are still widely used. This study investigates the impact of first-line sunitinib versus pazopanib on survival outcomes with second-line nivolumab. Methods We conducted a retrospective analysis of 245 patients with mRCC from the Turkish Oncology Group Kidney Cancer Consortium Database. Patients received first-line sunitinib or pazopanib, followed by second-line nivolumab. Primary endpoints were time to treatment failure (TTF) and overall survival (OS). Subgroup analyses were performed based on IMDC risk classification and presence of sarcomatoid features. Results A total of 245 patients who were treated with sunitinib or pazopanib monotherapy as first-line treatment followed by nivolumab as second-line treatment were included in this study. Median TTF following nivolumab initiation was similar between prior sunitinib and pazopanib groups (7.79 vs 7.72 months; p = 0.892). Median OS-2 was 27.21 months with prior sunitinib and 18.92 months with prior pazopanib (p = 0.496). In patients with sarcomatoid features (n = 20), those pretreated with pazopanib demonstrated numerically longer OS-2 compared to sunitinib (p = 0.023), although the small sample size limits definitive conclusions. Conclusion No significant differences in survival outcomes were observed between first-line sunitinib and pazopanib before nivolumab in mRCC. In the small subgroup with sarcomatoid features, pazopanib pre-treatment was associated with a numerically longer survival. These findings warrant cautious interpretation and further prospective validation, especially in resource-constrained settings.https://doi.org/10.1186/s12885-025-14654-3Metastatic renal cell cancerPazopanibSunitinibNivolumab |
| spellingShingle | Omer Faruk Kuzu Hatice Bolek Elif Sertesen Camoz Hilal Karakas Serhat Sekmek Saadet Sim Selver Isık Murat Günaltılı Aysun Fatma Akkus Deniz Tural Cagatay Arslan Sema Sezin Goksu Ozlem Nuray Sever Cengiz Karacin Mehmet Ali Nahit Sendur Nuri Karadurmus Emre Yekedüz Yüksel Ürün Impact of first-line tyrosine kinase inhibitor selection on survival outcomes with second-line nivolumab in metastatic renal cell carcinoma BMC Cancer Metastatic renal cell cancer Pazopanib Sunitinib Nivolumab |
| title | Impact of first-line tyrosine kinase inhibitor selection on survival outcomes with second-line nivolumab in metastatic renal cell carcinoma |
| title_full | Impact of first-line tyrosine kinase inhibitor selection on survival outcomes with second-line nivolumab in metastatic renal cell carcinoma |
| title_fullStr | Impact of first-line tyrosine kinase inhibitor selection on survival outcomes with second-line nivolumab in metastatic renal cell carcinoma |
| title_full_unstemmed | Impact of first-line tyrosine kinase inhibitor selection on survival outcomes with second-line nivolumab in metastatic renal cell carcinoma |
| title_short | Impact of first-line tyrosine kinase inhibitor selection on survival outcomes with second-line nivolumab in metastatic renal cell carcinoma |
| title_sort | impact of first line tyrosine kinase inhibitor selection on survival outcomes with second line nivolumab in metastatic renal cell carcinoma |
| topic | Metastatic renal cell cancer Pazopanib Sunitinib Nivolumab |
| url | https://doi.org/10.1186/s12885-025-14654-3 |
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