Clinical Outcomes of Sequential Cabozantinib and Axitinib After First-Line Nivolumab Plus Ipilimumab in Advanced Renal Cell Carcinoma: A Single-Center Exploratory Study

Background

Evidence regarding sequential vascular endothelial growth factor receptor tyrosine kinase inhibitor therapy after first-line nivolumab plus ipilimumab in advanced renal cell carcinoma (RCC) remains limited. This exploratory study described the clinical outcomes of sequential cabozantinib and axitinib administered as second- and third-line therapy, with additional analyses according to treatment order and early progressive disease (PD) status. Patients and Methods: We retrospectively reviewed 12 patients with advanced RCC who sequentially received cabozantinib and axitinib as second- and third-line therapy after first-line nivolumab plus ipilimumab between September 2018 and January 2026. Patients were categorized into cabozantinib-to-axitinib (n=8) and axitinib-to-cabozantinib (n=4) groups. Tumor response was assessed according to the Response Evaluation Criteria in Solid Tumors version 1.1. Combined time to treatment failure (TTF) was measured from second-line initiation to progression during third-line therapy or death; event-free patients were censored at last follow-up.