Oncologists Are Likely to Prescribe Fotivda for Advanced RCC

by Angela Maas

The renal cell carcinoma (RCC) therapeutic class boasts multiple agents, but a recent entrant is offering a new tool for certain patients. A Zitter Insights survey shows that the majority of oncologist respondents are likely to prescribe Aveo Oncology's Fotivda (tivozanib) for advanced RCC.On March 10, the FDA approved Fotivda for the treatment of adults with relapsed or refractory advanced RCC who have received at least two prior systemic therapies. It is the first FDA-approved therapy for this use.

For the Managed Care Oncology Index: Q4 2020, from Dec. 2, 2020, to Jan. 5, 2021, Zitter Insights polled 40 commercial payers with 132.0 million covered lives. Payers with 84% of lives expected they would manage the drug to label, while those with 10% of lives anticipated covering it more restrictively than its label. Respondents with 6% of lives expected that they would not require prior authorization for Fotivda. None of the payers anticipated not covering the drug.

The drug's approval was based on a handful of clinical trials, including TIVO-3, a Phase III study pitting it against Bayer's Nexavar (sorafenib). Payers covering 40% of lives said they are likely to use Fotivda to negotiate greater discounts for Nexavar, but those with 42% of lives said they are unlikely to take that action. Those covering 78% of lives do not expect to prefer Fotivda over Nexavar in advanced RCC and do not anticipate incentivizing oncologists to prescribe Fotivda over Nexavar.

Zitter Insights also surveyed 100 oncologists during the same time frame. Almost 70% said they were likely to prescribe Fotivda for advanced RCC, as well as prescribe it over Nexavar. Respondents were fairly evenly divided on whether they would refrain from prescribing Nexavar.

In the TIVO-3 trial, points out Mesfin Tegenu, CEO of RxParadigm, "Fotivda was able to show improved progression-free survival compared to sorafenib. However, Fotivda fell short in showing overall survival relative to sorafenib. The key takeaway for Fotivda will be its safety profile relative to current therapies for RCC. Therefore, Fotivda may be an option for a subset of patients who have failed previous therapies and require a more tolerable and safe option.

 From RADAR on Specialty Pharmacy