Tivozanib is a tyrosine kinase inhibitor (TKI) that is selective for vascular endothelial growth factor receptors. In the phase 3 TIVO-3 trial, which enrolled patients with metastatic renal-cell carcinoma (RCC) who had received 2 or 3 lines of systemic therapy, tivozanib was shown to extend progression-free survival relative to sorafenib, with better tolerability.1 Based on the results of the TIVO-3 trial, tivozanib was approved for adults with relapsed or refractory RCC who have received ≥2 previous systemic therapies in March 2021.2
In the follow-up reports of TIVO-3, several analyses confirmed the benefit of tivozanib. In long-term follow-up, objective response rate was 23% with tivozanib and 11% with sorafenib.3 Furthermore, tivozanib improved progression-free survival versus sorafenib regardless of previous treatment, including in those patients who had previously received multiple TKIs.4 Despite longer treatment exposure, tivozanib was also shown to have a better tolerability profile than sorafenib—a benefit that extended across age ranges and with or without previous receipt of immunotherapy.5,6 The investigators of these studies concluded that tivozanib remains a durably efficacious and tolerable option for heavily pretreated patients with advanced RCC.3-6
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