Kidney cancer is one of the 10 most common cancers affecting both men and women in the United States, accounting for 4% to 5% of all cancers. Most recent estimates have shown that about 81,610 new cases of kidney cancer will be diagnosed in 2024, with renal cell carcinoma (RCC). The treatment landscape of metastatic or unresectable locally advanced clear cell renal cell carcinoma (ccRCC) has changed over the past years with the approval of multiple combination regimens using immune checkpoint inhibitors (ICI) and vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI). However, this first‑line approach is associated with immense drug-related toxicity and financial burden. Recent research suggests that unlike traditional intermittent therapy, adaptive therapy modulates drug administration based on real-time tumor metrics to maintain a stable population of sensitive cells that suppress the growth of resistant clones. This phase II trial will assess the feasibility, patient acceptability, safety, and preliminary efficacy signals of a response-based multi-drug adaptive therapy approach with pembrolizumab-axitinib (pembro-axi) in patients with metastatic or unresectable locally advanced ccRCC.Clinical trial registration www.clinicaltrials.gov identifier is NCT06860386.
AIM:This study evaluated the real-world persistence, adherence, treatment discontinuation, and dose reduction of tepotinib in patients with metastatic non-small cell lung cancer (NSCLC). METHODS:This exploratory, retrospective study used McKesson's Biologics Specialty Pharmacy shipment data (10 February 2021-07 April 2025). Adults ≥50 years with NSCLC receiving tepotinib were included. Persistence was assessed as days supplied and covered; adherence as proportion of days covered (PDC), unadjusted and adjusted for gaps >42 days. Dose modifications, discontinuations, and time to last discontinuation were evaluated. Outcomes were assessed in the full cohort and a dose reduction subgroup. RESULTS:Full cohort included 436 patients (median age: 71 years; follow-up: 6.4 months). Median (range) days supplied and covered were 120 (15-1,950) days and 119 (15-1,388) days, respectively. Mean unadjusted PDC was 72.9% and adjusted PDC was 94.9%. Dose reduction was observed in 64 (14.7%) patients. Among these, median days supplied and covered since dose reduction were 120 (30-870) days and 120 (30-857) days, respectively. Mean unadjusted PDC was 78.1% and adjusted PDC was 92.7%. CONCLUSION:Tepotinib therapy showed consistent real-world persistence and adherence among patients with metastatic NSCLC. Dose reductions supported continuity of tepotinib therapy.
