CheckMate-9ER Shows Efficacy of Nivolumab/Cabozantinib Combo in RCC

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Bradley McGregor, MD, discusses the CheckMate-9ER trial of nivolumab plus cabozantinib versus sunitinib in patients with previously untreated advanced or metastatic renal cell carcinoma.

Bradley McGregor, MD, clinical director of Lank Center for Genitourinary Oncology, senior physician at Dana-Farber Cancer Institute, and instructor of Medicine at Harvard Medical School, discusses the CheckMate-9ER trial (NCT03141177) of nivolumab (Opdivo) plus cabozantinib (Cabometyx) versus sunitinib (Sutent) in patients with previously untreated advanced or metastatic renal cell carcinoma (RCC).

This trial enrolled patients from all of the International Metastatic RCC Database Consortium risk groups. The number of patients in each risk were comparable to real-world practice according to McGregor, with 20% to 25% having favorable risk, about 60% having intermediate risk, and about 20% having poor risk. The patients were evenly distributed through the United States, Europe, and the rest of the world.

The data from the initial analysis showed that there was a marked improvement in progression-free survival (PFS) at a median follow-up of 18 months. This improvement produced a hazard ratio of 0.51, with a median PFS of 16.6 months with the combination versus 8.3 months with sunitinib. The overall survival has not been reached in either group, but the hazard ratio favors the combination at 0.60. McGregor says the P value was also statistically significant. The subgroups also favored nivolumab and cabozantinib in this study.

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