Brian I. Rini, MD, discusses the dosing of nivolumab plus ipilimumab for patients with renal cell carcinoma.
Brian I. Rini, MD, professor of medicine and inaugural chief of Clinical Trials at Vanderbilt-Ingram Cancer Center, discusses the dosing of nivolumab (Opdivo) plus ipilimumab (Yervoy) for patients with renal cell carcinoma.
An abstract presented at the 2020 International Kidney Cancer Symposium (IKCS) looked at lowering the dosing of nivolumab and ipilimumab as a novel strategy for treating this patient population. Rini says the some of the early efficacy data released in the abstract suggested the lower dose of the combination was not as active as the dosing used in CheckMate 214 (NCT02231749).
In clinical practice, most physicians adjust doses as needed, but should be mindful of the balance of efficacy and toxicity, according to Rini. Treatment needs to be tolerable, but physicians should also be trying to get the best efficacy, especially in the first-line setting. Patients can have durable responses with nivolumab and ipilimumab and as this combination and other RCC combinations continue to be developed, questions on dosing, when to stop the drugs, and which patients require more aggressive or less aggressive treatment will have to be investigated. Rini is particularly interested in the effects of intensifying treatment in patients who need it and de-intensifying in patients who do not. That has no been researched in this setting yet.