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ONCAlert | Upfront Therapy for mRCC

Immunotherapy/TKI Combinations in Advanced RCC

Robert A. Figlin, MD
Published Online: 9:28 PM, Wed November 7, 2018

Robert A. Figlin, MD, director, Division of Hematology/Oncology, professor of biomedical sciences and medicine, Cedars-Sinai Medical Center, discusses the potential for immunotherapy/TKI combinations in the treatment of patients with advanced renal cell carcinoma (RCC).

Since the FDA approved the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) for patients with advanced intermediate- and poor-risk RCC, other immunotherapy regimens are moving through the pipeline with encouraging activity. Oncologists in general are becoming more comfortable treating patients with immuno-oncology agents as monotherapy or in combination, Figlin says. When TKIs and checkpoint inhibitors are combined, there is not a unique toxicity profile that physicians are not sensitive to already. An important factor will be choosing an endpoint to determine the necessary treatment strategy—is the goal objective response rate, progression-free survival, overall survival, or adverse event profile?

Figlin says conversations that physicians have with patients are evolving. Patients now understand these therapies not only offer a duration of treatment and maintenance of quality of life, but the possibility that their tumor can be reduced to the point of TKI discontinuation. Major advances have been made in RCC, but the remaining challenge is the lack of comparative trials.

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