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Atezolizumab and Bevacizumab Studied in Patients With Metastatic RCC

Bradley McGregor, MD
Published Online:7:38 PM, Mon March 23, 2020

Bradley McGregor, MD, clinical director of Lank Center for Genitourinary Oncology at the Dana-Farber Cancer Institute, discusses a trial investigating atezolizumab (Tecentriq) and bevacizumab (Avastin) in patients with metastatic renal cell carcinoma (RCC) and variant histologies and/or sarcomatoid features.

McGregor thinks that much of the data over the last few years has been focused on clear cell RCC, with trials like CheckMate-214; data from studies of pembrolizumab (Keytruda) and axitinib (Inlyta), or axitinib and nivolumab (Opdivo) excluded patients with non-clear cell and variant histology RCC. These patients do not do as well as patients with clear cell RCC, so McGregor and his colleagues started an investigator’s response trial. The purpose of this trial was to evaluate the combination of a VEGF inhibitor and an immune checkpoint blockade in patients with variant histologies or clear cell histology with sarcomatoid features.

The trial had a total of 60 patients, who received atezolizumab and bevacizumab based on the IMmotion 150 and 151 data. McGregor say this regimen was appealing because it was well tolerated by patients in those trials. Patients in this trial were given the standard dose of atezolizumab and 15 mg/kg of bevacizumab every 3 weeks. Patients were allowed to have prior therapy, which he says was unique for this setting. Over 1 and a half to 2 years, the study enrolled the 60 patients; 42 patients had variant histology RCC and 18 had clear cell RCC with sarcomatoid differentiation.

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