Planned Discontinuation of Tyrosine Kinase Inhibitor Therapy in Metastatic Renal Cell Carcinoma: Lessons for the Era of Immunotherapy

Target Oncol. 2024 Mar;19(2):175-180. doi: 10.1007/s11523-023-01031-y. Epub 2024 Feb 3.

Abstract

Several regimens combining immunotherapy and tyrosine kinase inhibitors (TKIs) have recently been validated for the first-line treatment of patients with metastatic renal cell carcinoma (mRCC). While immunotherapy is typically discontinued after 2 years in patients who neither progress nor experience limiting toxicity, according to the protocols of most recent phase III clinical trials, TKIs are to be continued until disease progression or the emergence of limiting toxicity. However, the prolonged use of TKIs is associated with significant toxicity and financial costs. This has sparked considerable debate about whether TKIs can be safely discontinued, particularly in mRCC patients who have achieved a verified complete response. This concise review examines the available evidence on TKI discontinuation in the context of mRCC management.

Publication types

  • Review

MeSH terms

  • Carcinoma, Renal Cell* / pathology
  • Humans
  • Immunotherapy
  • Kidney Neoplasms* / drug therapy
  • Kidney Neoplasms* / pathology
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Retrospective Studies
  • Tyrosine Kinase Inhibitors

Substances

  • Tyrosine Kinase Inhibitors
  • Protein Kinase Inhibitors