Arnab Basu, MD, MPH, FACP, discusses molecular residual disease-guided adjuvant therapy in patients with renal cell carcinoma, highlighting the rationale and goals of the MRD gate RCC clinical trial.
Arnab Basu, MD, MPH, FACP, assistant professor concentrating in genitourinary medical oncology at the University of Alabama in Birmingham, discusses molecular residual disease (MRD)-guided adjuvant therapy in patients with renal cell carcinoma, highlighting the rationale and goals of the MRD gate RCC clinical trial (NCT06005818).
In this video, Basu expands on this research by discussing the rationale for conducting this investigation.
0:10 | Over the last several years, we have tried to improve the outcomes for patients with high-risk resected renal cell carcinoma, and the recurrence rates can go up to almost 40%-50% in MRD patients. We've tried to improve overall survival and have tried to improve progression-free survival in these patients by doing adjuvant studies.
0:37 | Unfortunately, the adjuvant studies for renal cell carcinoma haven't been that promising except for only a couple. Sunitinib [Sutent] was positive for PFS but it was associated with a lot of toxicity, and KEYNOTE-564 [NCT03142334] is finally positive for progression-free survival, certainly, but also overall survival, but the magnitude of benefit is something to be discussed. It's not a very large benefit quite yet. So really, the question is, why did all these other trials that were done fail, and only 2 of these succeed?
1:11 | Perhaps the reason for that is when we treat patients for adjuvant therapy, we are coming up with a treatment that we think sort of works. We treat almost everyone. So there are 2 unknowns here: Who's got the disease, and whether it's the right regimen. What we are trying to do in this MRD gate study is try to improve that risk-benefit balance just a little bit by perhaps selecting patients who have minimal residual disease or MRD, and see if with just assigning patients based on MRD status, what kind of numbers do we get for the 1-year and hopefully, with further funding, looking at 2-year and 3-year outcomes?