Dr. Rini Discusses Tivozanib in Advanced RCC

Brian I. Rini, MD, professor of medicine, Cleveland Clinic, discusses the potential for tivozanib (Fotivda) in patients with advanced renal cell carcinoma (RCC).

Initial phase III results from the phase III TIVO-3 trial, which looked at the use of tivozanib versus sorafenib (Sutent) in patients who had received 2 or 3 prior lines of therapy, were presented by Rini at the 2019 Genitourinary Cancers Symposium. These drugs had previously been tested in the frontline setting in the TIVO-1 trial, and while tivozanib hadshown a slight advantage in progression-free survival (PFS) and response rates, while overall survival benefit was in favor of sorafenib, Rini says.For that reason, tivozanib did not receive FDA approval in the United States, he adds.

In TIVO-3, patients were randomized 1:1 to receive either tivozanib or sorafenib. Tivozanib demonstrated a statistically significant improvement in median PFS compared with sorafenib, at 5.6 months versus 3.9 months, respectively. Moreover, 2-year PFS rates were 18% versus 5% in favor of tivozanib. There was also a response rate advantage observed with tivozanib (18% vs 8%).

Rini adds that there were 2 particularly impressive factors with tivozanib. With VEGF TKIs, response rates are high, but generally short-lived.However, in the case of tivozanib, responses seemed to be durable. The drug was also very well-tolerated, Rini notes, suggesting it may work well in combination with a checkpoint inhibitor.