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Giulia Claire Giudice: Strategies for RCC patients progressing on ICIs
Giulia Claire Giudice/X
Apr 1, 2025, 09:47

Giulia Claire Giudice: Strategies for RCC patients progressing on ICIs

Giulia Claire Giudice, Medical Doctor at University Hospital of Parma, shared an article on X:

“Newly published JAMA Oncology!

Deep dive into strategies for RCC patients progressing on ICIs. A comprehensive review on the latest data and emerging approaches.

Read here.

ICI Rechallenge in Melanoma and NSCLC:

  • CheckMate 064: Nivolumab → Ipilimumab: better ORR & OS.
  • Keynote-002: Pembrolizumab after ipilimumab showed PFS but no OS benefits.
  • NSCLC: Retreating with ICIs showed some benefit, especially post-toxicity discontinuation.

Retrospective RCC Data.

Small studies show modest efficacy for ICI rechallenge in RCC:

  • ORR ~23%, PFS ~5.7 months.
  • Higher responses in prior responders to ICI.

Prospective Phase 2 Trials:

  • KEYNOTE-146: Pembrolizumab + Lenvatinib → ORR 59%, PFS 11.6 months.
  • Nivolumab + Sitravatinib: minimal benefit, trial terminated early.
  • Meta-analysis of 10 trials: ORR 19%, PFS 5.6 months.

Phase 3 Trials:

  • CONTACT-03: Atezolizumab + Cabozantinib ≠ better than Cabozantinib alone.
  • TiNivo-2: Tivozanib + Nivolumab failed to improve PFS over Tivozanib alone.
  • Suggests no clear benefit for ICI continuation in ICI-refractory RCC.

Future Directions: Novel Trials & Approaches.

  • New ICI targets: LAG-3, TIM-3, TIGIT, OX40, 4-1BB.
  • Early CAR-T trials for RCC.
  • MDSC targeting to enhance immune response.
  • Focus on better patient selection for ICI rechallenge.

Takeaway: ICI rechallenge shows limited benefit in RCC.

Future research should focus on novel targets & patient selection!

A huge thanks to my amazing mentors Brian Rini, Katy Beckermann and to our fantastic co-author Paulo Amaral for their precious contribution!”

Immunotherapy Strategies After Immune Checkpoint Inhibitor Exposure in Renal Cell Carcinoma.

Authors: Giulia Claire Giudice, et al.

Giulia Claire Giudice: Strategies for RCC patients progressing on ICIs

4-1BB atezolizumab Brian Rini Cabozantinib cancer CAR-T CheckMate 064 fight against cancer Giulia Claire Giudice Global fight against cancer ICIs immune checkpoint inhibitor immunotherapy ipilimumab Katy Beckermann Keynote-002 LAG-3 MDSC Melanoma nivolumab NSCLC OncoDaily Oncology OX40 Paulo Amaral pembrolizumab RCC renal cell carcinoma sitravatinib TIGIT TIM-3 TiNivo-2 Tivozanib University Hospital of Parma
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