Renal Cell Carcinoma

Although patients who develop brain metastases from renal cell carcinoma typically have poor outcomes, investigators from Yale University have identified a subset of patients who demonstrated extended survival.¹Those patients with a single metastasis were less likely to develop central nervous system\ recurrence after local therapy. This is an encouraging development because these patients have historically been excluded from participating in clinical trials and receiving aggressive treatment regimens.

According to updated data from the phase I/II PIVOT-02 trial presented at the 2018 ASCO Annual Meeting, the combination of NKTR-214 plus the PD-1 inhibitor nivolumab demonstrated promising antitumor activity in patients with advanced solid tumors, particularly in PD-L1–negative patients.

According to findings from the phase III CARMENA trial presented at the 2018 ASCO Annual Meeting, sunitinib monotherapy demonstrated noninferiority compared with cytoreductive nephrectomy in combination with sunitinib in patients with synchronous metastatic renal cell carcinoma.

Shilpa Gupta, MD, assistant professor of Medicine in the Hematology, Oncology, and Transplantation Division, University of Minnesota, discusses phase Ib and phase II studies of pembrolizumab (Keytruda) with bevacizumab (Avastin) for the treatment of metastatic renal cell carcinoma during the 2018 ASCO Annual Meeting.

Neoadjuvant and adjuvant therapies are being incorporated into the course of treatment for patients with renal cell carcinoma (RCC), as these approaches may be able to help reduce the risk of recurrence after surgery, according to David M. Nanus, MD. Tyrosine kinase inhibitors (TKIs) and immunotherapy agents especially have demonstrated benefit in the adjuvant setting for patients with high-risk RCC.

Patients with renal cell carcinoma have seen a change in standard of care as novel therapies and combinations are quickly approved, says Toni K. Choueiri, MD.

Cabozantinib has been approved by the European Commission for previously untreated patients with intermediate- or poor-risk advanced renal cell carcinoma, based on a meaningful progression-free survival improvement versus sunitinib in the CABOSUN trial, according to Ipsen, which codevelops the treatment with Exelixis.

Toni K. Choueiri, MD, a medical oncologist at Dana-Farber Cancer Institute, discusses how clinical trials can help improve cancer treatments for patients with metastatic renal cell carcinoma, a largely incurable and lethal disease. He also shares recent statistics on the low clinical enrollment numbers as well as how many could potentially be enrolling for newer treatments. 

CB-839 has been granted Fast Track designation by the FDA in combination with cabozantinib for the treatment of patients with metastatic renal cell carcinoma who have received 1 or 2 prior lines of therapy, according to Calithera Biosciences, the manufacturer of the first-in-class glutaminase inhibitor.

Antibiotics administered within 30 days of initiating treatment with PD-1 and PD­-L1 inhibitors were associated with poorer survival and increased risk for disease progression in patients with renal cell carcinoma or non-small cell lung cancer.

The FDA approved several indications throughout the month of April 2018. A number of drugs were granted priority review and Fast Track designation. The FDA also halted all clinical trials using tazemetostat as treatment, and new initiatives were introduced to help ease the development of genetic and genomic-based tests. Check out our list of all FDA happenings from April 2018.

A 4-week dosing schedule for nivolumab has been approved by the European Commission for the treatment of patients with advanced melanoma and previously treated renal cell carcinoma, Bristol-Myers Squibb (BMS), the manufacturer of the PD-1 inhibitor, has announced.

Brad McGregor, MD, a medical oncologist at Dana-Farber Cancer Institute, discusses the future of combination therapies in the treatment landscape of renal cell carcinoma. He highlights the positive results from a few combinations that have been tested in clinical trials.