Clinical Trial Data in Relapsed/Refractory Renal Cell Carcinoma
Experts Matthew Campbell, MD, MS, and Brian Rini, MD, provide a brief review of recent clinical data in the setting of relapsed/refractory renal cell carcinoma.
EP: 1.Advanced Renal Cell Carcinoma: An Evolving Treatment Armamentarium
EP: 2.Factors in Selecting First-Line Therapy for Patients With Advanced RCC
EP: 3.Adverse Event Management in Patients With Advanced RCC
EP: 4.Renal Cell Carcinoma: Overlapping Toxicity in TKI/IO Combination Therapy
EP: 5.First-Line Clinical Trial Data in Advanced Renal Cell Carcinoma
EP: 6.Clinical Trial Data in Relapsed/Refractory Renal Cell Carcinoma
EP: 7.Advanced Renal Cell Carcinoma: Nuancing Triplet Therapy Trial Results
EP: 8.Interpreting Adjuvant Therapy Trial Results in Advanced RCC
EP: 9.Overview of First-Line Treatment Options for Advanced RCC
EP: 10.First-Line Therapy for Advanced RCC: Optimizing Adverse Event Management
EP: 11.Frontline Clinical Trial Data in Advanced Renal Cell Carcinoma
EP: 12.Novel Treatment Strategies in the Setting of Advanced Renal Cell Carcinoma
EP: 13.Unmet Needs in the Management of Advanced Renal Cell Carcinoma
EP: 14.Advanced Renal Cell Carcinoma: What is the Role of Adjuvant Therapy?
EP: 15.Role of Immunotherapy in Non–Clear Cell Renal Cell Carcinoma
EP: 16.Practice Pearls for Optimizing the Management of Advanced RCC
EP: 17.Recap: Experts Discuss Treatment Methodologies in RCC
Transcript:
Brian I. Rini, MD: Let’s transition to talk about refractory treatment…and switching between the doublets. If you have an ipilimumab-nivolumab progressor, are you giving a single-agent TKI [tyrosine kinase inhibitor] or are you giving an I/O [immuno-oncology]–TKI doublet?
Matthew T. Campbell, MD, MS: It’s a great question. We participated in Study 111, in which patients got lenvatinib-pembrolizumab in the second- or third-line setting, and the progression-free survival was around 11.5 months. Patients had a good treatment experience on ipilimumab-nivolumab until their cancer grew and did not have major toxicity. That approach is more appealing than a patient who had major toxicity with their maintenance phase of nivolumab. If patients had cabozantinib-nivolumab as frontline therapy, there are times when I’ll discuss lenvatinib-pembrolizumab as a second-line option. I’ll often still use single-agent cabozantinib or a combination of lenvatinib plus everolimus in a later-line setting and not pair it with I/O. The studies that we have ongoing—like the CONTACT-03 trial, which is cabozantinib with or without atezolizumab—will be helpful. We’re interested in seeing those data, as well as other studies comparing continuing I/O or not. I don’t think we have the answer to know if patients benefit from continuation on I/O after initial progression on I/O.
Brian I. Rini, MD: I agree. Single-agent TKI is the unexciting standard in that setting, but those trials with nivolumab too will provide insight. The practice is all over the map. The lenvatinib-pembrolizumab data in that setting is pretty impressive, but they’re single-arm data. I’m a believer that we need randomized data because we’ve been fooled with single-arm data before.
Transcript edited for clarity.
