Ep. 1: Positioning Tivozanib in Today’s RCC Treatment Landscape

Ulka Vaishampayan, MBBS University of Michigan | David Braun, MD, PhD Yale School of Medicine | Rahul Gosain, MD, MBA Wilmot Cancer Institute | Rohit Gosain, MD Roswell Park Comprehensive Cancer Center

Key Points

• Tyrosine kinase inhibitors (TKIs) or belzutifan are the standard of care for patients with advanced renal cell carcinoma (RCC).

• Tivozanib is the most recently approved TKI for advanced RCC and has more robust data on post-immunotherapy efficacy.

• Balancing toxicity and efficacy is a primary goal when treating RCC in the second-line or later setting.

• Compared to the other approved TKIs, tivozanib has a notably favorable toxicity profile.

Tivozanib for RCC in Second and Later Lines of Therapy

During a roundtable discussion with the cohosts of the Oncology Brothers podcast, Rahul Gosain, MD, MBA, of Wilmot Cancer Institute, and Rohit Gosain, MD, of Roswell Park Comprehensive Cancer Center,  medical oncologists discussed the treatment landscape for patients with advanced RCC. 

David Braun, MD, PhD, of Yale School of Medicine, reviewed the standard second-line treatments for relapsed or refractory RCC, including cabozantinib, lenvatinib plus everolimus, axitinib, tovizanib, and belzutifan. Among the TKIs, tivozanib has some of the most up-to-date data, as the other agents were initially evaluated before immunotherapy-based regimens were adopted in the first line, said Dr. Braun.

Ulka Vaishampayan, MBBS, of University of Michigan, discussed the TIVO-3 trial that led to the approval of tivozanib. In the study, tivozanib improved outcomes compared with sorafenib and was well tolerated, with low rates of toxicities associated with anti-VEGF TKIs. The doctors agreed that toxicity is a significant component of selecting treatments in the advanced RCC setting, given the palliative intent of therapy.