Toni Choueiri, MD:PD-L1 testing probably is the most used and, to some degree, abused biomarker in immuno-oncologyby far. And it has a lot of variables: What antibody? Is it an immune cell, tumor cell? Who is staining it? And in kidney cancer, specifically, we know that for PD-L1positive patients with metastatic RCC, it’s the worst. We have shown that from previous studies using VEGF tyrosine kinase inhibitors.
In nivolumab-treating patients in the CheckMate-025 trial, the study versus everolimus, PD-L1 testing confirmed prognostic but not predictive values. This means the benefit of nivolumab was irrespective of PD-L1 testing. And here we are on CheckMate-214there’s a different signal. Patients who were PD-L1positive or PD-L1–negative had the overall survival benefit—both of them—but the benefit was much more pronounced in patients with PD-L1–positive disease.
So, at this time, the story is evolving. It’s still very intriguing. The primary endpoints that were met were independent of PD-L1 testing. I think this may become more relevant perhaps with other combinations rather than the nivolumab/ipilimumab combination. To me, based on the CheckMate-214 resultsthe large frontline study of nivolumab/ipilimumab—this brings back PD-L1 to the equation, perhaps not yet for testing in practice but at least for us clinical investigators and clinical trialists. We should just take it in consideration sometimes, stratify for future trials, or at least collect the tissue and look how patient outcome is based on PD-L1 testing. At some point, we almost drop that.
Transcript edited for clarity.
Comparing Choices for IO/TKI Combinations in Advanced RCC
May 2nd 2024During a Case-Based Roundtable® event, Shilpa Gupta, MD, led a discussion on the combination of immunotherapy and tyrosine kinase inhibitors for patients with advanced renal cell carcinoma in the second article of a 2-part series.
Read More
Enhancing Precision in Immunotherapy: CD8 PET-Avidity in RCC
March 1st 2024In this episode of Emerging Experts, Peter Zang, MD, highlights research on baseline CD8 lymph node avidity with 89-Zr-crefmirlimab for the treatment of patients with metastatic renal cell carcinoma and response to immunotherapy.
Listen
Roundtable Roundup April: Renal Cell Carcinoma
April 27th 2024In separate, live virtual events, Arnab Basu, MD, MPH, and Robert J. Motzer, MD, asked participants which therapy they would choose for a patient with clear cell renal cell carcinoma (RCC) and why they would make that choice.
Read More