Pazopanib together with 6–8 cycles of sintilimab followed by single use of pazopanib in the second-line treatment of advanced renal cell carcinoma

BACKGROUND: The aim of the study was to investigate the temporary combination of anti-PD-1 plus targeted therapy followed by single targeted therapy in advanced renal cell carcinoma (RCC) as second-line therapy. METHODS: A total of 17 patients from Fudan University Shanghai Cancer Center (FUSCC) with advanced clear cell RCC were enrolled. They were treated with sunitinib (50 mg/day; 2 weeks on and 1 weeks off) as first-line therapy. After progression of the disease, sintilimab (200 mg iv/q3w) in combination with pazopanib (800 mg/day) were used. After 6–8 cycles of immunotherapy, patients were treated with pazopanib only. Cox proportional hazards models was used to evaluate the risk factors. RESULTS: Three patients reached partial response (PR) after second-line treatment, while 12 patients remained stable. Two patients had progressive disease and 1 of them died due to disease progression. The median progression-free survival (PFS) for second-line therapy was 12.2 months. Cox analysis revealed that IMDC score (HR: 0.041, P=0.01) was the only factor that was correlated with progression free survival. CONCLUSIONS: Tyrosine kinase inhibitors (TKIs), together with 6–8 cycles of immune checkpoint inhibitor (ICI) agents followed by the single use of a TKI, are a feasible way to treat metastatic clear cell RCC (ccRCC) patients as second-line treatment.