{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T06:12:12Z","timestamp":1765260732971,"version":"3.46.0"},"reference-count":54,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Recordati Rare Diseases Germany GmbH","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The efficacy and safety of tivozanib for the treatment of advanced or metastatic renal cell carcinoma (mRCC) have been established in the first-line setting in the Phase III trial TIVO-1. Methods: The prospective T-Rex study conducted in German clinical practice evaluated the safety, effectiveness and impact on quality of life (QoL) of first-line treatment with tivozanib in 32 patients with mRCC recruited between May 2019 and April 2021. Results: Recruited patients were predominantly elderly, with 53.1% aged over 75 years. Patients received a median of 6.5 tivozanib treatment cycles and the median time on treatment was 5.7 months. Overall, 78.1% of patients experienced treatment-related adverse events, including diarrhea, nausea and hypotension\/hypertension. A clinical (i.e., complete or partial) response was observed in 46.9% of patients. Patients\u2019 QoL remained stable from baseline to the end of treatment and most symptomatic toxicities resolved by the final treatment cycle, with the exclusion of dry skin, itching, and hand\u2013foot syndrome. Conclusions: These data demonstrate that first-line treatment with tivozanib was associated with clinical activity, favorable tolerability, and stable QoL in patients with mRCC treated in everyday clinical practice across Germany, including those with advanced age.<\/jats:p>","DOI":"10.3390\/cancers17243910","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T09:17:36Z","timestamp":1765185456000},"page":"3910","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First-Line Treatment with Tivozanib for Metastatic Renal Cell Carcinoma in Real-World Settings Across Germany: Results of the Prospective, Non-Interventional, Post-Approval Study T-Rex"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2083-7687","authenticated-orcid":false,"given":"Viktor","family":"Gr\u00fcnwald","sequence":"first","affiliation":[{"name":"Institute for Urologic 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Hegemann","sequence":"additional","affiliation":[{"name":"Urological Clinic Sindelfingen, 71065 Sindelfingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Baumann","sequence":"additional","affiliation":[{"name":"Urological Practice, 04129 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horst","family":"Brenneis","sequence":"additional","affiliation":[{"name":"Urological Practice, 66953 Pirmasens, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Seidel","sequence":"additional","affiliation":[{"name":"Group Practice for Urology, 04315 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olrik","family":"Rau","sequence":"additional","affiliation":[{"name":"Urological Practice, 38855 Wernigerode, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silke","family":"Schirrmacher-Memmel","sequence":"additional","affiliation":[{"name":"Oncological Practice, 63739 Aschaffenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Hellmis","sequence":"additional","affiliation":[{"name":"Urologicum Duisburg, 47169 Duisburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claus F.","family":"Fieseler","sequence":"additional","affiliation":[{"name":"Urological Practice, 88048 Friedrichshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Doehn","sequence":"additional","affiliation":[{"name":"Urologikum L\u00fcbeck, 23566 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Ziske","sequence":"additional","affiliation":[{"name":"GFO Kliniken, 53840 Troisdorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Distelrath","sequence":"additional","affiliation":[{"name":"MVZ for Oncology and Urology, 26389 Wilhelmshaven, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6098-1301","authenticated-orcid":false,"given":"Norbert","family":"Marschner","sequence":"additional","affiliation":[{"name":"Practice for Interdisciplinary Oncology and Hematology, 79110 Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Ivanyi","sequence":"additional","affiliation":[{"name":"Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Herold","sequence":"additional","affiliation":[{"name":"Recordati Rare Diseases Germany GmbH, 89075 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca 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