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Opinion|Videos|February 20, 2025

Second-Line Therapy Options

Author(s)Sumanta Kumar Pal, MD

A panelist discusses how second-line treatment options for kidney cancer have evolved through multiple clinical trials including Study 205, METEOR, CONTACT-03, TIVO-3, TiNivo-2, and LITESPARK-005, which have demonstrated varying efficacy across different patient populations and prior therapies, particularly noting the impact of prior immunotherapy exposure on treatment selection and the need for careful consideration of historical trial data in the context of modern treatment paradigms.

Episodes in this series

1 KOL is featured in this series.

EP. 1 Patient With Favorable-Risk mRCC and Goals of Therapy

1 KOL is featured in this series.

EP. 2 Second-Line Therapy Options

1 KOL is featured in this series.

EP. 3 Lessons from TiNivo-2 and CONTACT-03

1 KOL is featured in this series.

EP. 4 Understanding Patient-Reported Outcomes in RCC

1 KOL is featured in this series.

EP. 5 Case (cont.): Dr Pal’s Approach Toward 2L Therapy Selection

1 KOL is featured in this series.

EP. 6 Sequencing Through Multiple Lines of Therapy for mRCC

1 KOL is featured in this series.

EP. 7 AE Management With TKIs and Belzutifan

1 KOL is featured in this series.

EP. 8 Potentially Groundbreaking Research in RCC

Video content above is prompted by the following:

What are the second-line options for this patient per the NCCN guidelines for kidney cancer?
Please provide a brief overview of the efficacy and safety data supporting these options, as appropriate (eg, phase 2 Study 205, METEOR, control arm of CONTACT-03, TIVO-3, control arm of TiNivo-2, LITESPARK-005)
How do the populations of these trials compare? Distinctions in approved indications (eg, line of therapy; prior ICI).
What are the trends that have emerged with long-term follow up?
What guidance can you offer community oncologists when critically weighing the evidence from studies of the second-line options?
What are the limitations of applying data from older studies in modern practice (eg, prior ICI)?

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