Matthew T. Campbell, MD, MS

Matthew T. Campbell, MD, assistant professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, discusses the unmet needs for patients with RCC and sarcomatoid dedifferentiation.

According to Campbell, there are many unmet needs in the kidney cancer space in regard to both clear cell and non-clear cell RCC (ccRCC, nccRCC). A retrospective single-institution study conducted by MD Anderson Cancer Center examined 48 patients with RCC, 41 of which had sarcomatoid dedifferentiated ccRCC and 7 had sarcomatoid dedifferentiated nccRCC.

The study revealed that while ICI therapy was effective in patients with sarcomatoid dedifferentiated ccRCC, treating patients with nccRCC remains a challenge. More trials examining this patient population are needed to fully understand and provide patients with the best treatment options.

 There are a number of unmet needs. Currently, the most exploration has been done in clear cell kidney cancer, which is the most common kidney cancer, but we still have significant unmet needs in patients with non-clear cell kidney cancer. Far fewer trials have been done and far fewer trials are ongoing, and that's a patient population that we need to continue to focus on. We also struggle knowing optimal initial treatment for patients as well as optimal sequence for patients. We still have a tremendous way to go even though we are making substantial improvements.

 I think sites of disease and disease burden are large challenges. I'm particularly interested in bone metastasis. This is a site of disease that tends to cause a lot of pain and suffering, decreased response to treatment, oftentimes and increased risk of death. We also struggle with patients with extensive liver metastasis in brain metastasis, in addition to patients that are refractory to initial systemic treatment.

Articles

Matthew T. Campbell, MD, discusses the unmet needs for patients with renal cell carcinoma and sarcomatoid dedifferentiation. 

Addressing Unmet Needs in Renal Cell Carcinoma

Matthew T. Campbell, MD, MS, assistant professor in the Department of Genitourinary Medical Oncology of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discusses trials investigating cabozantinib (Cabometyx) in patients with renal cell carcinoma (RCC).

For patients with RCC that have aggressive disease, including those with extensive bone disease, especially in their spinal column, or extensive liver disease, physicians sometimes only have one chance to treat them. Campbell thinks the combination of nivolumab (Opdivo) and cabozantinib, which in now approved in advanced RCC, is a good fit for this patient population.

An important question in this space, which may be answered when the CONTACT-03 (NCT04338269) data are published, is how to best treat patients who have already progressed on immune-oncology treatment or pembrolizumab (Keytruda) plus axitinib (Inlyta). Campbell wonders if cabozantinib plus immunotherapy with atezolizumab (Tecentriq) will enhance patient’s long-term disease control versus using cabozantinib alone.

Another study of cabozantinib in RCC is COSMIC-313 (NCT03937219), which is looking at cabozantinib combined with nivolumab and ipilimumab (Yervoy) in previously untreated patients with advanced or metastatic RCC. This trial will show if the combination has the ability to achieve complete responses in patients and if it will improve the durability of response. This is an important study in this setting, according to Campbell.

Videos

Matthew T. Campbell, MD, MS, discusses trials investigating cabozantinib in patients with renal cell carcinoma.

Matthew T. Campbell, MD, MS | Authors

Articles

Addressing Unmet Needs in Renal Cell Carcinoma

Upcoming Trials Show Promise With Cabozantinib in RCC