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Tivozanib Tolerability Shows Potential Advantage for Patients with Advanced RCC

Wednesday, May 20, 2020

Oncology Nursing News sat down with Brian Rini, MD, from the Vanderbilt-Ingram Cancer Center (VICC), to discuss results from the phase III TIVO03 trial, and its potential impact on patients with relapsed or refractory renal cell carcinoma.


As you know, there are several VEGF TKIs that are approved. So, the biggest advantage to tivozanib (Fotivda) is tolerability. It’s a very clean drug, hits VEGF pretty much, and has a very good tolerability profile in terms of side effects and need for dose interruption or reduction – which is very minimal. One thing where my mindset has changed now that we have immune therapy combinations that can be curative, is that when we are using single agent TKIs, we’re really just trying to control disease. Because we’re not curing those patients, and they can be on (TKI therapy) for many months or years, tolerability is really the key thing. I don’t think there are huge efficacy differences among TKIs. There are some – tivozanib was better than sorafenib in the TIVO-3 trial – but at the end of the day, in my opinion, it’s really more about tolerability.

Patients, appropriately, always want more options. I’ve never met a patient who doesn’t look down the road a little bit and say, “Gee doc, if this one doesn’t work, is there something else?” I totally get it. So, I think even though we on the physician side might say, “Do we really need another TKI?” From a patient standpoint, they absolutely want more options. Having a tolerable options, especially in this late line setting, is a potential advantage to patients. I often describe to patients that we’re just trying to get as many shots on goal as possible. You never know when one drug might work wonderfully or not at all. Even among the VEGF TKIs, they work differently in different patients for reasons I don’t think we understand. So, I think it adds to our weapons in this disease.

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