I think these are active agents. They’re important agents in our armamentarium for treating renal cell carcinoma, and I think as you look at the future, we’re going to be looking at these agents more in combination with immunotherapy [I/O], after immune therapy regimens, or potentially after other combinations.
Obviously, I think at this point we have a lot of great options at the front and center. We have cabozantinib for those who are unable to receive immunotherapy, and then we have nivolumab/ipilimumab, the combination of pembrolizumab with axitinib, and avelumab with axitinib. There’s always this debate over given there’s this multitude of options available, do I choose the combination of nivolumab with ipilimumab or do I choose a VEGF-I/O combination? There are lots of debates about which option is better for which patient. I think 1 trial we’re really excited about is the idea of using the combination of nivolumab and ipilimumab but actually adding cabozantinib to that regimen.
There’s a randomized phase III trial open for those patients with intermediate- and poor-risk disease where everyone receives the combination, nivolumab and ipilimumab, and then patients are randomized to either receive cabozantinib at a dose of 40 mg daily or placebo. And so I think that will be really exciting data that will hopefully help shape frontline therapy. And then I think obviously, that’s great, but there are patients who don’t respond to initial therapies, and so evolving that field. We’ve heard some data on the combination of pembrolizumab with lenvatinib following immunotherapy with or without VEGF, which has been very exciting.
And then we await the trials that are accruing right now, frontline trials looking at nivolumab and cabozantinib or sunitinib as well as combination, a trial looking at pembrolizumab with lenvatinib versus lenvatinib with everolimus versus sunitinib. So there are lots of exciting data, and I think that therapy for renal cell carcinoma continues to evolve as we get new trials and new data presented.
Transcript edited for clarity.
Case: A 70-Year-Old Man with Intermediate-Risk RCC
A 70-year-old Caucasian man presented to ER complaining of blood in his urine and abdominal pain.
H & P
Labs
Imaging
Treatment
Follow-up
Key Takeaways From QOL and Use of Steroids With IO-Based RCC Regimens
May 6th 2024During a Case-Based Roundtable® event, Ulka Vaishampayan, MBBS, discussed the safety and quality-of-life data for ipilimumab plus nivolumab in patients with advanced renal cell carcinoma in the second article of a 2-part series.
Read More
Enhancing Precision in Immunotherapy: CD8 PET-Avidity in RCC
March 1st 2024In this episode of Emerging Experts, Peter Zang, MD, highlights research on baseline CD8 lymph node avidity with 89-Zr-crefmirlimab for the treatment of patients with metastatic renal cell carcinoma and response to immunotherapy.
Listen
Comparing Choices for IO/TKI Combinations in Advanced RCC
May 2nd 2024During a Case-Based Roundtable® event, Shilpa Gupta, MD, led a discussion on the combination of immunotherapy and tyrosine kinase inhibitors for patients with advanced renal cell carcinoma in the second article of a 2-part series.
Read More
Beyond the First-Line: Economides on Advancing Therapies in RCC
February 1st 2024In our 4th episode of Emerging Experts, Minas P. Economides, MD, unveils the challenges and opportunities for renal cell carcinoma treatment, focusing on the lack of therapies available in the second-line setting.
Listen
Sustained Treatment-Free Survival in RCC Seen With Nivolumab and Ipilimumab
April 30th 2024Nivolumab monotherapy plus salvage nivolumab/ipilimumab demonstrated superior treatment-free survival rates among patients with advanced renal cell carcinoma, especially in patients with favorable risk profiles.
Read More
Roundtable Roundup April: Renal Cell Carcinoma
April 27th 2024In separate, live virtual events, Arnab Basu, MD, MPH, and Robert J. Motzer, MD, asked participants which therapy they would choose for a patient with clear cell renal cell carcinoma (RCC) and why they would make that choice.
Read More